Organization
TSL OAK LANE, LLC
Active
Other names
Oak Lane Retirement
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PEARY D WOOD (MANAGER)
(503) 719-5614
Entity
Organization
Contact information
Practice address
727 SW ROGUE RIVER AVE, GRANTS PASS, OR 97526-2777
(541) 476-7727
Mailing address
727 SW ROGUE RIVER AVE, GRANTS PASS, OR 97526-2777
(541) 476-7727
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524973
—
OR
05
—
528093
—
OR
Enumeration date
06/15/2020
Last updated
06/15/2020
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