Provider Demographics
NPI:1093015547
Name:OAKLAND HEALTHCARE MANAGEMENT
Entity Type:Organization
Organization Name:OAKLAND HEALTHCARE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BIENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-917-1297
Mailing Address - Street 1:737 N HIGHWAY ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:IA
Mailing Address - Zip Code:51560-4532
Mailing Address - Country:US
Mailing Address - Phone:712-482-6810
Mailing Address - Fax:712-482-6879
Practice Address - Street 1:737 N HIGHWAY ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:IA
Practice Address - Zip Code:51560-4532
Practice Address - Country:US
Practice Address - Phone:712-482-6810
Practice Address - Fax:712-482-6879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA780147314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA165230Medicare Oscar/Certification