Healthcare Provider Details

I. General information

NPI: 1447355730
Provider Name (Legal Business Name): OAKLAND HEIGHTS ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S ENGDAHL AVE
OAKLAND NE
68045-1434
US

IV. Provider business mailing address

207 S ENGDAHL AVE
OAKLAND NE
68045-1419
US

V. Phone/Fax

Practice location:
  • Phone: 402-685-5683
  • Fax: 402-685-5684
Mailing address:
  • Phone: 402-685-5683
  • Fax: 402-685-5684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALF 119
License Number StateNE

VIII. Authorized Official

Name: HARRY P GOODRICH
Title or Position: MAYOR OF OAKLAND, NE
Credential:
Phone: 402-685-5683