Provider Demographics
NPI:1184709602
Name:OAKCREST MANOR NURSING HOME LLC
Entity type:Organization
Organization Name:OAKCREST MANOR NURSING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUNJABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-272-5511
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:512-272-8031
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:512-272-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility