Provider Demographics
NPI:1407382005
Name:NORTH-OAKLAND RESIDENTIAL SERVICES, INC
Entity Type:Organization
Organization Name:NORTH-OAKLAND RESIDENTIAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:COVILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-969-2392
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-0216
Mailing Address - Country:US
Mailing Address - Phone:248-969-2392
Mailing Address - Fax:248-969-0391
Practice Address - Street 1:106 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-4975
Practice Address - Country:US
Practice Address - Phone:248-969-2392
Practice Address - Fax:248-969-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS630012317320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities