LIVE OAK HOLDINGS, LLC (NPI# 1972961415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972961415 |
| Entity Type | Organization |
| Organization Name | LIVE OAK HOLDINGS, LLC |
| Other Organization Name | GOVERNOR'S RIDGE RETIREMENT |
| Practice Address |
300 E Devereaux St Decatur TX 76234-3033 |
| Practice Telephone | 9406271104 |
| Practice Fax Number | 9406271159 |
| Mailing Telephone | 9406271104 |
| Mailing Fax Number | 9406271159 |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |
| Authorized Official Name | ALLAN ERSELIUS (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 5623019819 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 141222 | TX | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Governor's Ridge Retirement | Doing Business As Name - Organization |
| Street Address |
300 E DEVEREAUX ST |
| City | DECATUR |
| State | TX |
| Zip Code | 76234-3033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013274794 | Live Oak Management, L.p. | Assisted Living Facility | 300 E Devereaux St, Decatur, TX 76234-3033 | 2012-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477102028 | Ursula Eileen Fernandez-plata | Technician | 1221 Cr 4371, Decatur, TX 76234 | 2019-09-06 |
| 1649772377 | Stephanie Jennie Roddenberry | Nurse Practitioner | 2301 S Fm 51 Ste 500, Decatur, TX 76234 | 2018-03-08 |
| 1467731679 | David Gatti Corless | Dentist | 301 W. Main St., Decatur, TX 76234 | 2011-08-05 |
| 1376830067 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 805 W Business Hwy 380, Decatur, TX 76234 | 2011-07-01 |
| 1356667844 | Richard Ryan Ooten | Specialist/Technologist, Other | 239 Harvey Lane, Decatur, TX 76234 | 2010-04-09 |
| 1003049032 | Advanced Gastroenterology Associates, Pa | Internal Medicine | 607 Medical Center Drive, Suite 2600, Decatur, TX 76234 | 2009-08-25 |
| 1831346188 | Rufus John Nelson | Dentist | 1710 S Hwy 51 Ste 20,pmb #176, 1000 W Business Hwy 380, Decatur, TX 76234 | 2008-08-19 |
| 1851558449 | James Lee Hendrick | Counselor | 2304 Fm 51 South, Decatur, TX 76234 | 2008-05-21 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1366625022 | Tower Mutual Holding Company, Inc. | Durable Medical Equipment & Medical Supplies | 206 N. State Street, Decatur, TX 76234 | 2007-12-17 |
| Find all providers in zip 76234 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013381235 | Altrus | Assisted Living Facility | 3363 Luxembourg Cir, Decatur, GA 30034-5418 | 2015-11-27 |
| 1013274794 | Live Oak Management, L.p. | Assisted Living Facility | 300 E Devereaux St, Decatur, TX 76234-3033 | 2012-04-18 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1952638769 | Greater Works, Inc. | Assisted Living Facility | 2551 Rainshower Dr, Decatur, GA 30034-2164 | 2009-11-16 |
| 1730373416 | Ambassador of Angels Inc. | Assisted Living Facility | 3782 Citation Dr, Decatur, GA 30034-2128 | 2007-09-05 |
| 1316069099 | Eagle Ridge of Decatur, Lp | Assisted Living Facility | 875 W Mckinley Ave, Decatur, IL 62526-3287 | 2007-04-04 |
| 1497893879 | Avondale Health Services Inc. | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2007-02-01 |
| 1184662017 | Morningside of Decatur, L.p. | Assisted Living Facility | 2115 Point Mallard Dr Se, Decatur, AL 35601-6765 | 2006-06-03 |
| 1740662402 | Avondale Health Services Inc | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2015-06-18 |
| 1851600324 | Avondale Health Services Inc. | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2010-10-01 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.