Oakland Manor Nursing Center, LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

108720 Issued in TX

Legal business name

OAKLAND MANOR NURSING CENTER, LP

Practice address

1400 N Main St
Giddings, TX 78942-1360

Phone

(979) 542-1755

Fax

(979) 542-7002

NPI assigned

Nov 11, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Carly Lynn Wallace, LVN

Title

MDS / PPS Nurse

Phone

(979) 542-1755

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679554018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N MAIN ST",
            "city": "GIDDINGS",
            "state": "TX",
            "postal_code": "789421360",
            "telephone_number": "979-542-1755",
            "fax_number": "979-542-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N MAIN ST",
            "city": "GIDDINGS",
            "state": "TX",
            "postal_code": "789421360",
            "telephone_number": "979-542-1755",
            "fax_number": "979-542-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND MANOR NURSING CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "CARLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MDS / PPS NURSE",
        "authorized_official_telephone_number": "979-542-1755",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "108720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Giddings, TX
• Providers in Giddings, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.