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General NPI Number Information
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NPI Number | 1487426532
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Entity Type | Organization
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Legal Business Name | OAK TREE MANOR, INC.
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 7770 128TH ST
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City | SEMINOLE
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State | FL
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Zip | 33776-4100
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Country | US
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Telephone | 727-398-1286
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Fax | 727-499-0956
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Provider Business Mailing Address
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Address Line | 1114 18TH ST SW
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City | LARGO
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State | FL
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Zip | 33770-4800
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Country | US
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Telephone | 727-398-1286
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Fax | 727-499-0956
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | CHRISTINE MARIE GIBREE
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Credential |
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Telephone | 727-398-1286
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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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