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General NPI Number Information
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NPI Number | 1326385907
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Entity Type | Organization
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Legal Business Name | OAK PARK MANOR OPERATOR, LLC
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 501 S COLLEGE AVE
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City | CLAREMONT
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State | CA
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Zip | 91711-5527
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Country | US
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Telephone | 909-626-0117
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Fax | 909-625-1654
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Provider Business Mailing Address
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Address Line | 4250 PENNSYLVANIA AVE SUITE 107
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3369
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Country | US
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Telephone | 818-273-8900
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Fax | 818-273-8910
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Authorized Official
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Title or Position | VP OF FINANCIAL SERVICES
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Name | MELYN CADABES
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Credential |
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Telephone | 818-273-8900
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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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