Healthcare Provider Details

I. General information

NPI: 1912125592
Provider Name (Legal Business Name): OXFORD SENIOR LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AZALEA DR
OXFORD MS
38655-8113
US

IV. Provider business mailing address

3723 FAIRVIEW INDUSTRIAL DR SE SUITE 270
SALEM OR
97302-1177
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-9600
  • Fax:
Mailing address:
  • Phone: 503-485-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number800
License Number StateMA

VIII. Authorized Official

Name: JON HARDER
Title or Position: MANAGER
Credential:
Phone: 503-485-4600