Provider Demographics
NPI:1245194315
Name:SHIRLEY ADAMS DBA FIVE OAKS REST HOME
Entity type:Organization
Organization Name:SHIRLEY ADAMS DBA FIVE OAKS REST HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-546-1232
Mailing Address - Street 1:611 OLD WELAKA RD
Mailing Address - Street 2:
Mailing Address - City:WELAKA
Mailing Address - State:FL
Mailing Address - Zip Code:32193-2172
Mailing Address - Country:US
Mailing Address - Phone:386-546-1232
Mailing Address - Fax:386-467-9998
Practice Address - Street 1:611 OLD WELAKA RD
Practice Address - Street 2:
Practice Address - City:WELAKA
Practice Address - State:FL
Practice Address - Zip Code:32193-2172
Practice Address - Country:US
Practice Address - Phone:386-546-1232
Practice Address - Fax:386-467-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-12
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility