Provider Demographics
NPI:1295407955
Name:OAKTOWN COMMUNITY HOMES
Entity type:Organization
Organization Name:OAKTOWN COMMUNITY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGERS
Authorized Official - Prefix:
Authorized Official - First Name:DYMOND / LAMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER / BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:248-289-2243
Mailing Address - Street 1:653 BAGLEY ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-2612
Mailing Address - Country:US
Mailing Address - Phone:248-289-2243
Mailing Address - Fax:
Practice Address - Street 1:512 LUTHER AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-2572
Practice Address - Country:US
Practice Address - Phone:248-289-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric