Provider Demographics
NPI:1245396076
Name:OAKRIDGE SUPPORT SERVICES, INC
Entity Type:Organization
Organization Name:OAKRIDGE SUPPORT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-829-7599
Mailing Address - Street 1:1021 INDUSTRIAL PARK RD SW
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-8338
Mailing Address - Country:US
Mailing Address - Phone:218-829-7599
Mailing Address - Fax:218-829-7498
Practice Address - Street 1:1021 INDUSTRIAL PARK RD SW
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-8338
Practice Address - Country:US
Practice Address - Phone:218-829-7599
Practice Address - Fax:218-829-7498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health