Provider Demographics
NPI:1245614288
Name:OAK HOUSE CORPORATION
Entity Type:Organization
Organization Name:OAK HOUSE CORPORATION
Other - Org Name:OAK HOUSE TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TANISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARAVEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-721-9699
Mailing Address - Street 1:7919 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-2512
Mailing Address - Country:US
Mailing Address - Phone:916-721-9699
Mailing Address - Fax:916-721-9699
Practice Address - Street 1:7987 OAK AVE
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-2512
Practice Address - Country:US
Practice Address - Phone:916-721-9699
Practice Address - Fax:916-721-5302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility