Provider Demographics
NPI:1629224563
Name:OAKLEAF TOLEDO LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:OAKLEAF TOLEDO LIMITED PARTNERSHIP
Other - Org Name:OAKLEAF VILLAGE SENIORS COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GULLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-863-4640
Mailing Address - Street 1:4220 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-2577
Mailing Address - Country:US
Mailing Address - Phone:419-885-3934
Mailing Address - Fax:
Practice Address - Street 1:4220 N HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-2577
Practice Address - Country:US
Practice Address - Phone:419-885-3934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1999R302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization