Provider Demographics
NPI:1831640515
Name:MARION OAKS ASSISED LIVING
Entity type:Organization
Organization Name:MARION OAKS ASSISED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUCHITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-209-1655
Mailing Address - Street 1:3590 SW 137TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-2231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3590 SW 137TH LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-2231
Practice Address - Country:US
Practice Address - Phone:352-307-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12557310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility