Provider Demographics
NPI:1629768189
Name:SPRING OAK CHRISTIANSBURG LLC
Entity Type:Organization
Organization Name:SPRING OAK CHRISTIANSBURG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-719-8125
Mailing Address - Street 1:1514 ROUTE 138
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3789
Mailing Address - Country:US
Mailing Address - Phone:732-719-8125
Mailing Address - Fax:
Practice Address - Street 1:1140 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-4222
Practice Address - Country:US
Practice Address - Phone:540-381-0919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility