Provider Demographics
NPI:1881019883
Name:MISSION OAKS ASSISTED LIVING
Entity type:Organization
Organization Name:MISSION OAKS ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-330-3900
Mailing Address - Street 1:10780 N US HIGHWAY 301
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-3505
Mailing Address - Country:US
Mailing Address - Phone:352-330-3900
Mailing Address - Fax:352-330-3999
Practice Address - Street 1:10780 N US HIGHWAY 301
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:FL
Practice Address - Zip Code:34484-3505
Practice Address - Country:US
Practice Address - Phone:352-330-3900
Practice Address - Fax:352-330-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11808310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility