Provider Demographics
NPI:1366575714
Name:OAKDALE HEALTH ENTERPRISES INC
Entity type:Organization
Organization Name:OAKDALE HEALTH ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INTERIM CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-581-4768
Mailing Address - Street 1:4501 68TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-1712
Mailing Address - Country:US
Mailing Address - Phone:763-520-4319
Mailing Address - Fax:763-520-4829
Practice Address - Street 1:302 HATCH AVE
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470-4302
Practice Address - Country:US
Practice Address - Phone:763-520-4319
Practice Address - Fax:763-520-4829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2024-12-30
Deactivation Date:2008-02-13
Deactivation Code:
Reactivation Date:2008-03-20
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590015507OtherRAILROAD MEDICARE
MN203675400Medicaid
109971OtherUCARE
MN82395JOOtherBLUE CROSS
MN203675400Medicaid