| Laguna Enterprises, Inc. | |
|
1309 Old Mill Rd Moore OK 73160-6644 | |
| (405) 338-7674 | |
| Not Available |
| Full Name | Laguna Enterprises, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1309 Old Mill Rd, Moore, Oklahoma |
| Authorized Official Name and Position | Jose Solis (MAJORITY SHARE HOLDER) |
| Authorized Official Contact | 4053387674 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laguna Enterprises, Inc. Po Box 58218 Oklahoma City OK 73157-8218 | Laguna Enterprises, Inc. 1309 Old Mill Rd Moore OK 73160-6644 Ph: (405) 338-7674 |
| NPI Number | 1902673239 |
|---|---|
| Provider Enumeration Date | 12/06/2023 |
| Last Update Date | 12/06/2023 |
| Certification Date | 12/06/2023 |
| Medicare PECOS PAC ID | 9234580341 |
|---|---|
| Medicare Enrollment ID | O20240112001154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902673239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (NU) | Primary |
| Provider Name | Jose Solis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972841476 PECOS PAC ID: 0143671255 Enrollment ID: I20240112001290 |
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