Healthcare Provider Details

I. General information

NPI: 1164035408
Provider Name (Legal Business Name): OAKS INTEGRATED CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1461 PERKINS LN
EDGEWATER PARK NJ
08010-2207
US

IV. Provider business mailing address

770 WOODLANE RD
WESTAMPTON NJ
08060-3804
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-5928
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ANGELA RICE
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 609-267-5928