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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