Provider Demographics
NPI:1699534719
Name:NURTURED IN NATURAL ENVIRONMENTS RANCH, LLC
Entity type:Organization
Organization Name:NURTURED IN NATURAL ENVIRONMENTS RANCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:LOBPRIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-934-4010
Mailing Address - Street 1:4327 S ATLANTA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4335
Mailing Address - Country:US
Mailing Address - Phone:918-934-4010
Mailing Address - Fax:
Practice Address - Street 1:4900 W 71ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74131-3459
Practice Address - Country:US
Practice Address - Phone:918-934-4010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)