Provider Demographics
NPI:1427099472
Name:COUNTY OF OAKLAND
Entity type:Organization
Organization Name:COUNTY OF OAKLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-858-1293
Mailing Address - Street 1:1200 N TELEGRAPH RD
Mailing Address - Street 2:BLDG. 34 EAST
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-0432
Mailing Address - Country:US
Mailing Address - Phone:248-858-1415
Mailing Address - Fax:248-858-4026
Practice Address - Street 1:1200 N TELEGRAPH RD
Practice Address - Street 2:BLDG. 34 EAST
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-0432
Practice Address - Country:US
Practice Address - Phone:248-858-1415
Practice Address - Fax:248-858-4026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI638510314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI61 2085240Medicaid
MI09803OtherBCBS PROVIDER ID
MI2085240Medicaid
MI09803OtherBCBS PROVIDER ID