MEDICARE: THE OAKS SENIOR LIVING OPERATIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1164351623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OAKS SENIOR LIVING OPERATIONS LLC

Provider Business Mailing Address
First Line	:	707 EMGE RD
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-2118
Country	:	US
Telephone Number	:	636-542-5220
Fax Number	:

Provider Business Practice Location Address
First Line	:	707 EMGE RD
Second Line	:
City	:	O FALLON
State	:	MO
Zip	:	63366-2118
Country	:	US
Telephone Number	:	636-542-5220
Fax Number	:

Authorized Official
Title or Position	:	VP BUSINESS STRATEGIES
Name	:	JORDAN RYAN
Credential	:
Telephone Number	:	507-251-6356

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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