MEDICARE: OAKLEAF PROPERTY MANAGEMENT

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	332U00000X	Home Delivered Meals		IA

General Provider Information

NPI Number	:	1609077916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKLEAF PROPERTY MANAGEMENT

Provider Business Mailing Address
First Line	:	1309 NEBRASKA STREET
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51105-1416
Country	:	US
Telephone Number	:	712-255-3665
Fax Number	:	712-252-0155

Provider Business Practice Location Address
First Line	:	1309 NEBRASKA ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51105-1416
Country	:	US
Telephone Number	:	712-255-3665
Fax Number	:	712-252-0155

Authorized Official
Title or Position	:	RESIDENT SERVICES MANAGER
Name	:	DIXIE KAYE GORS
Credential	:
Telephone Number	:	712-255-3665

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	08/22/2020

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