Oak Senior Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

OAK SENIOR CARE, LLC

Practice address

111 S Walnut St
Oakland, IL 61943-7232

Phone

(217) 346-2042

Fax

(217) 346-2046

NPI assigned

Nov 2, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marijo Eisbrenner, PHD, CNA

Title

Director

Phone

(941) 799-1552

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Oaks Manor Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1164023693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 974",
            "city": "OAKLAND",
            "state": "IL",
            "postal_code": "619430974",
            "telephone_number": "217-346-2042",
            "fax_number": "217-346-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S WALNUT ST",
            "city": "OAKLAND",
            "state": "IL",
            "postal_code": "619437232",
            "telephone_number": "217-346-2042",
            "fax_number": "217-346-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK SENIOR CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "EISBRENNER",
        "authorized_official_first_name": "MARIJO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "941-799-1552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, CNA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDPH STATE ASSISTED LIVING LICENSE",
            "identifier": "5201964",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Oaks Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Kathleen Boothe, P.T.
• Emily Clapp, LCSW
• Laurie N. Dean, MS SLP-CCC
• Hospital & Medical Foundation of Paris, Inc.
• Ashlie Lee, PTA
• Oakland Ambulance
• Oakland Comm Unit School Dist 5
• Oakland Community Fire Protection District Ambulance Service

• All providers in Oakland, IL
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.