Provider Demographics
NPI:1447355730
Name:OAKLAND HEIGHTS ASSISTED LIVING
Entity type:Organization
Organization Name:OAKLAND HEIGHTS ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR OF OAKLAND, NE
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-685-5683
Mailing Address - Street 1:207 S ENGDAHL AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68045-1419
Mailing Address - Country:US
Mailing Address - Phone:402-685-5683
Mailing Address - Fax:402-685-5684
Practice Address - Street 1:205 S ENGDAHL AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NE
Practice Address - Zip Code:68045-1434
Practice Address - Country:US
Practice Address - Phone:402-685-5683
Practice Address - Fax:402-685-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEALF 119310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========11Medicaid