Provider Demographics
NPI:1275253874
Name:LAUREN OBERG LLC
Entity type:Organization
Organization Name:LAUREN OBERG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-643-7492
Mailing Address - Street 1:4180 KELLER RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-1200
Mailing Address - Country:US
Mailing Address - Phone:517-643-7492
Mailing Address - Fax:
Practice Address - Street 1:4180 KELLER RD STE D
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1200
Practice Address - Country:US
Practice Address - Phone:517-618-1779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health