Provider Demographics
NPI:1134605777
Name:OAKLEY PLACE LLC
Entity type:Organization
Organization Name:OAKLEY PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-221-7740
Mailing Address - Street 1:PO BOX 4047
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-0047
Mailing Address - Country:US
Mailing Address - Phone:785-221-7740
Mailing Address - Fax:
Practice Address - Street 1:618 SW OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1954
Practice Address - Country:US
Practice Address - Phone:785-221-7740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSB089082310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility