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General NPI Number Information
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NPI Number | 1518955970
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Entity Type | Organization
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Legal Business Name | OAK PARK, LLC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 303 ELM ST
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City | PERTH AMBOY
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State | NJ
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Zip | 08861-4015
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Country | US
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Telephone | 732-442-9540
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Fax | 732-442-9106
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Provider Business Mailing Address
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Address Line | 51 CRAGWOOD RD SUITE # 101
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City | SOUTH PLAINFIELD
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State | NJ
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Zip | 07080-2405
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Country | US
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Telephone | 908-315-3400
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Fax | 908-226-5177
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Authorized Official
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Title or Position | COMPTROLLER
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Name | HESHY KLEIN
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Credential |
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Telephone | 908-315-3400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 061209
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License Number State | NJ
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