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General NPI Number Information
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NPI Number | 1083256515
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Entity Type | Organization
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Legal Business Name | THE OAKS HEALTHCARE LLC
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 1000 METHODIST OAKS DR
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City | ORANGEBURG
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State | SC
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Zip | 29115-1815
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Country | US
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Telephone | 770-500-2705
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Fax |
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Provider Business Mailing Address
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Address Line | 240 CHANDLER WALK
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City | LOGANVILLE
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State | GA
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Zip | 30052-3141
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JOSEPH CLAY FOWLER
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Credential |
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Telephone | 770-500-2705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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