OAKTREE MANOR ASSISTED LIVING INC. NPI 1558964742

NPI Information

  • NPI: 1558964742
  • Provider Name: OAKTREE MANOR ASSISTED LIVING, INC.
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 25D2202869
  • Address: 60139 COTTON GIN PORT RD
    AMORY, MS
    ZIP 38821
  • Phone: (662) 256-8406

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NPI Details

OAKTREE MANOR ASSISTED LIVING, INC. is an assisted living facility in Amory, MS. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. OAKTREE MANOR ASSISTED LIVING, INC. NPI is 1558964742. The provider is registered as an organization entity type.

The provider's business location address is:

60139 COTTON GIN PORT RD
AMORY, MS
ZIP 38821-520
Phone: (662) 256-8406
Fax: (662) 256-8883

The provider's authorized official is Kenneth A Long .
The authorized official title is President and has the following contact phone number (662) 401-8930.

The CLIA number assigned to this NPI record is 25D2202869 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/19/2020 and was last updated on 11/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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