Provider Demographics
NPI:1659197242
Name:OAK MANOR, INC.
Entity type:Organization
Organization Name:OAK MANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN LNFA
Authorized Official - Phone:979-249-7527
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:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility