Individual ProviderJordan ListSocial WorkerBehavioral Health & Social Service ProvidersPractice Address4300 S Harvard Ave, Tulsa, OK 74135-2619(918) 728-2228PECOS EnrollmentBased on the most recent information from CMS, provider Jordan List does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1528685419Provider TypeIndividualFull NameList, JordanCredentialBAGenderMaleSole ProprietorYesEnumeration Date6/26/2020Last Updated9/29/2023Contact InformationPractice LocationPractice Address4300 S Harvard Ave, Tulsa, OK 74135-2619Phone(918) 728-2228FaxUnlisted FaxMailing LocationMailing Address4144 E 38th St, Tulsa, OK 74135-2502PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense20487-POklahomaCode171M00000XDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer