Provider Demographics
NPI:1013274794
Name:LIVE OAK MANAGEMENT, L.P.
Entity type:Organization
Organization Name:LIVE OAK MANAGEMENT, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-374-3804
Mailing Address - Street 1:9450 FM 2210 E
Mailing Address - Street 2:
Mailing Address - City:POOLVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76487-5028
Mailing Address - Country:US
Mailing Address - Phone:940-374-3804
Mailing Address - Fax:940-374-3069
Practice Address - Street 1:300 E DEVEREAUX ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3033
Practice Address - Country:US
Practice Address - Phone:940-627-1104
Practice Address - Fax:940-627-1159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132992310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility