Provider Demographics
NPI:1124870464
Name:LORETTAS ADULT DAYCARE INC
Entity type:Organization
Organization Name:LORETTAS ADULT DAYCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-992-4209
Mailing Address - Street 1:3027 WILLOWOOD RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-9725
Mailing Address - Country:US
Mailing Address - Phone:405-992-4209
Mailing Address - Fax:
Practice Address - Street 1:1404 NW 170 TH EDMOND
Practice Address - Street 2:
Practice Address - City:EDMOND OKLAHOMA 73012
Practice Address - State:OK
Practice Address - Zip Code:73034
Practice Address - Country:US
Practice Address - Phone:405-994-4209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care