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General NPI Number Information
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NPI Number | 1841580164
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Entity Type | Organization
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Legal Business Name | OAKHOUSE CORPORATION
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Dates
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Enumeration Date | 04/08/2011
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 7919 OAK AVE
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-2512
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Country | US
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Telephone | 916-721-9699
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Fax | 916-721-5302
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Provider Business Mailing Address
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Address Line | 7919 OAK AVE
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-2512
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Country | US
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Telephone | 916-721-9699
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Fax | 916-721-5302
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. JAMES TILLMAN
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Credential | CADC II
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Telephone | 916-721-9699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 340013AP
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License Number State | CA
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