Provider Demographics
NPI:1245820554
Name:ST.OAKS CARE CENTER LLC
Entity type:Organization
Organization Name:ST.OAKS CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:HECK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:601-365-1438
Mailing Address - Street 1:83 WHITE CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:CARRIERE
Mailing Address - State:MS
Mailing Address - Zip Code:39426-7473
Mailing Address - Country:US
Mailing Address - Phone:601-365-1438
Mailing Address - Fax:
Practice Address - Street 1:83 WHITE CHAPEL RD
Practice Address - Street 2:
Practice Address - City:CARRIERE
Practice Address - State:MS
Practice Address - Zip Code:39426-7473
Practice Address - Country:US
Practice Address - Phone:601-365-1438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based