Provider Demographics
NPI:1457785073
Name:STEWART HEALTHCARE ENTERPRISES, LLC
Entity Type:Organization
Organization Name:STEWART HEALTHCARE ENTERPRISES, LLC
Other - Org Name:LIFECARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-735-6122
Mailing Address - Street 1:2411 SPRINGER DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-3955
Mailing Address - Country:US
Mailing Address - Phone:405-329-4545
Mailing Address - Fax:405-735-6701
Practice Address - Street 1:1900 E 15TH ST STE 500C
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6696
Practice Address - Country:US
Practice Address - Phone:405-735-6122
Practice Address - Fax:405-735-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-30
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7819251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
37-7701OtherMEDICARE PTAN
OK7819OtherSTATE LICENSE NUMBER