Provider Demographics
NPI:1518159250
Name:OAKMONT PERSONAL CARE
Entity Type:Organization
Organization Name:OAKMONT PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN,
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LOUGHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-240-7424
Mailing Address - Street 1:204 COCOVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MANSURA
Mailing Address - State:LA
Mailing Address - Zip Code:71350-4266
Mailing Address - Country:US
Mailing Address - Phone:318-240-7424
Mailing Address - Fax:318-240-7464
Practice Address - Street 1:204 COCOVILLE RD
Practice Address - Street 2:
Practice Address - City:MANSURA
Practice Address - State:LA
Practice Address - Zip Code:71350-4266
Practice Address - Country:US
Practice Address - Phone:318-240-7424
Practice Address - Fax:318-240-7464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11475311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home