Healthcare Provider Details

I. General information

NPI: 1144290198
Provider Name (Legal Business Name): COMMUNITY LIVING CT OAKHURST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40131 HIGHWAY 49
OAKHURST CA
93644-9560
US

IV. Provider business mailing address

PO BOX 2349 40131 HWY 49
OAKHURST CA
93644-2349
US

V. Phone/Fax

Practice location:
  • Phone: 559-683-2244
  • Fax: 559-683-0220
Mailing address:
  • Phone: 559-683-2244
  • Fax: 559-683-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. JOANN J WESTON
Title or Position: ADMINISTRATOR
Credential: NHA #4258
Phone: 559-683-2244