Provider Demographics
NPI:1932538063
Name:OAKTREE ASSOCIATES INC
Entity Type:Organization
Organization Name:OAKTREE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMSW
Authorized Official - Phone:269-372-9658
Mailing Address - Street 1:7734 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-9796
Mailing Address - Country:US
Mailing Address - Phone:269-372-9658
Mailing Address - Fax:269-743-1000
Practice Address - Street 1:7734 S 8TH ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-9796
Practice Address - Country:US
Practice Address - Phone:269-372-9658
Practice Address - Fax:269-743-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010962601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty