Provider Demographics
NPI:1366497828
Name:OAK MANOR INC
Entity Type:Organization
Organization Name:OAK MANOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIEVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-743-6537
Mailing Address - Street 1:111 COLLEGE
Mailing Address - Street 2:
Mailing Address - City:SCHULENBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78956
Mailing Address - Country:US
Mailing Address - Phone:979-743-6537
Mailing Address - Fax:979-743-6537
Practice Address - Street 1:111 COLLEGE
Practice Address - Street 2:
Practice Address - City:SCHULENBURG
Practice Address - State:TX
Practice Address - Zip Code:78956
Practice Address - Country:US
Practice Address - Phone:979-743-6537
Practice Address - Fax:979-743-6537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251J00000X251J00000X
TX332BP3500X332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251J00000XAgenciesNursing Care
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition