Provider Demographics
NPI:1952577371
Name:OAKWOOD HEALTHCARE LLC
Entity Type:Organization
Organization Name:OAKWOOD HEALTHCARE LLC
Other - Org Name:OAKWOOD HEALTHCARE & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:COLEV
Authorized Official - Middle Name:J
Authorized Official - Last Name:GESTETNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-673-7000
Mailing Address - Street 1:2109 RED LION RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-1711
Mailing Address - Country:US
Mailing Address - Phone:215-673-7000
Mailing Address - Fax:
Practice Address - Street 1:2109 RED LION RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1711
Practice Address - Country:US
Practice Address - Phone:215-673-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA011402314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA395110Medicare Oscar/Certification