Provider Demographics
NPI:1255934972
Name:OAKWOOD VALLEY SERVICES, LLC
Entity type:Organization
Organization Name:OAKWOOD VALLEY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DBA
Authorized Official - Phone:417-291-8701
Mailing Address - Street 1:4506 LEROY LN
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:MO
Mailing Address - Zip Code:64865-8496
Mailing Address - Country:US
Mailing Address - Phone:417-291-8701
Mailing Address - Fax:
Practice Address - Street 1:519 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-8572
Practice Address - Country:US
Practice Address - Phone:417-509-8256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)