Provider Demographics
NPI:1457398133
Name:OAK MANOR, INC.
Entity Type:Organization
Organization Name:OAK MANOR, INC.
Other - Org Name:SCHULENBURG REGENCY NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:979-743-6537
Mailing Address - Street 1:111 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:SCHULENBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78956-1601
Mailing Address - Country:US
Mailing Address - Phone:979-743-6537
Mailing Address - Fax:979-743-3485
Practice Address - Street 1:111 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:SCHULENBURG
Practice Address - State:TX
Practice Address - Zip Code:78956-1601
Practice Address - Country:US
Practice Address - Phone:979-743-6537
Practice Address - Fax:979-743-3485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005287314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX IDENTIFICATION NUMBER
TX455908Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER