Healthcare Provider Details

I. General information

NPI: 1871430348
Provider Name (Legal Business Name): NEW OASIS RESIDENTIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11029 W LINCOLN ST
AVONDALE AZ
85323-4558
US

IV. Provider business mailing address

11029 W LINCOLN ST
AVONDALE AZ
85323-4558
US

V. Phone/Fax

Practice location:
  • Phone: 520-229-7194
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ABDI ADEN ABDI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 520-229-7194