Provider Demographics
NPI:1912359407
Name:OAKCREST OPERATING LLC
Entity Type:Organization
Organization Name:OAKCREST OPERATING LLC
Other - Org Name:OAKCREST NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PELEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-253-6934
Mailing Address - Street 1:9808 CROFFORD LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-1004
Mailing Address - Country:US
Mailing Address - Phone:512-272-5511
Mailing Address - Fax:
Practice Address - Street 1:9808 CROFFORD LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-1004
Practice Address - Country:US
Practice Address - Phone:512-272-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-07
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676291Medicare Oscar/Certification