Provider Demographics
NPI:1891070793
Name:OAKGREEN COMMONS, LLC
Entity Type:Organization
Organization Name:OAKGREEN COMMONS, LLC
Other - Org Name:OAK PARK SENIOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEMIEUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-454-4801
Mailing Address - Street 1:13936 LOWER 59TH ST N
Mailing Address - Street 2:
Mailing Address - City:OAK PARK HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55082-7065
Mailing Address - Country:US
Mailing Address - Phone:651-439-9995
Mailing Address - Fax:651-454-4783
Practice Address - Street 1:13936 LOWER 59TH ST N
Practice Address - Street 2:
Practice Address - City:OAK PARK HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55082-7065
Practice Address - Country:US
Practice Address - Phone:651-439-9995
Practice Address - Fax:651-454-4783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN355161310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility