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Organization
OAK PARK HEALTHCARE, LLC
Active
Organization
OAK PARK HEALTHCARE, LLC
Active
Other names
Oak Park Convalescent Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PERRY BYRON DEFOOR (OWNER)
(423) 308-1845
Entity
Organization
Contact information
Practice address
1625 OAK PARK BLVD, PLEASANT HILL, CA 94523-4487
(925) 935-5222
(925) 935-5211
Mailing address
801 BROAD ST, SUITE 300, CHATTANOOGA, TN 37402-2671
(423) 308-1845
(423) 398-1844
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055049
TPAN
—
Enumeration date
01/19/2010
Last updated
09/08/2016
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