Healthcare Provider Details

I. General information

NPI: 1437562105
Provider Name (Legal Business Name): LTA BUSINESS CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 W OKLAHOMA ST
TULSA OK
74127-3027
US

IV. Provider business mailing address

2426 W OKLAHOMA ST
TULSA OK
74127-3027
US

V. Phone/Fax

Practice location:
  • Phone: 918-607-3343
  • Fax:
Mailing address:
  • Phone: 918-607-3343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOK

VIII. Authorized Official

Name: WILLANA TURNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 918-607-3343