Organization
OAK FENCE SENIOR LIVING LLC
Active
Parent organization
OAK FENCE SENIOR LIVING LLC
Other names
Apple Valley Congregate Living Health Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
OAK FENCE SENIOR LIVING LLC
Authorized official
THAN T AYE (OWNER)
(909) 967-1872
Entity
Organization
Contact information
Practice address
20135 ONEIDA RD, APPLE VALLEY, CA 92307-5207
(909) 967-1872
Mailing address
6067 OAK FENCE LN, LANCASTER, CA 93536-1795
(909) 967-1872
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013674472
—
CA
05
—
1497140222
—
CA
01
—
550005416
DEPARTMENT OF PUBLIC HEALTH
CA
Enumeration date
11/19/2021
Last updated
03/22/2023
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