Provider Demographics
NPI:1487426532
Name:OAK TREE MANOR, INC.
Entity type:Organization
Organization Name:OAK TREE MANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GIBREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-398-1286
Mailing Address - Street 1:1114 18TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-4800
Mailing Address - Country:US
Mailing Address - Phone:727-398-1286
Mailing Address - Fax:727-499-0956
Practice Address - Street 1:7770 128TH ST
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33776-4100
Practice Address - Country:US
Practice Address - Phone:727-398-1286
Practice Address - Fax:727-499-0956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility