Healthcare Provider Details

I. General information

NPI: 1669403036
Provider Name (Legal Business Name): OAKS NURSING HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 NURSING HOME RD
MARSHALLVILLE GA
31057-3715
US

IV. Provider business mailing address

777 NURSING HOME RD
MARSHALLVILLE GA
31057-3715
US

V. Phone/Fax

Practice location:
  • Phone: 478-967-2223
  • Fax: 478-967-2224
Mailing address:
  • Phone: 478-967-2223
  • Fax: 478-967-2224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1094120
License Number StateGA

VIII. Authorized Official

Name: MR. WILLIAM JULE WINDHAM
Title or Position: OWNER/ OPERATOR - ADMINISTRATOR
Credential:
Phone: 478-967-2223