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General NPI Number Information
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NPI Number | 1407382005
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Entity Type | Organization
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Legal Business Name | NORTH-OAKLAND RESIDENTIAL SERVICES, INC
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 106 S WASHINGTON ST
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City | OXFORD
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State | MI
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Zip | 48371-4975
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Country | US
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Telephone | 248-969-2392
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Fax | 248-969-0391
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Provider Business Mailing Address
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Address Line | PO BOX 216
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City | OXFORD
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State | MI
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Zip | 48371-0216
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Country | US
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Telephone | 248-969-2392
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Fax | 248-969-0391
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | ROGER COVILL
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Credential |
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Telephone | 248-969-2392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | AS630012317
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License Number State | MI
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