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General NPI Number Information
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NPI Number | 1861734907
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Entity Type | Organization
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Legal Business Name | THE GARDENS AT OAKLAND, LLC
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 715 HULL ISLAND DR
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City | OAKLAND
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State | FL
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Zip | 34787-9174
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Country | US
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Telephone | 407-654-0387
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Fax |
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Provider Business Mailing Address
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Address Line | 715 HULL ISLAND DR
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City | OAKLAND
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State | FL
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Zip | 34787-9174
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Country | US
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Telephone | 407-654-0387
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLEY KEOPPEN
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Credential |
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Telephone | 407-947-5687
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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 | AL11088
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License Number State | FL
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