Provider Demographics
NPI:1801462791
Name:OAKLEY ASSISTED LIVING II LLC
Entity type:Organization
Organization Name:OAKLEY ASSISTED LIVING II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICOLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-219-6165
Mailing Address - Street 1:1449 BUTTONS CT
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-2002
Mailing Address - Country:US
Mailing Address - Phone:925-679-8452
Mailing Address - Fax:
Practice Address - Street 1:1449 BUTTONS CT
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-2002
Practice Address - Country:US
Practice Address - Phone:925-679-8452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility