Healthcare Provider Details

I. General information

NPI: 1417565821
Provider Name (Legal Business Name): OASIS RESIDENTIAL CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3865 SHIRLENE PL
LA MESA CA
91941-7429
US

IV. Provider business mailing address

PO BOX 15591
SAN DIEGO CA
92175-5591
US

V. Phone/Fax

Practice location:
  • Phone: 619-727-7335
  • Fax:
Mailing address:
  • Phone: 619-727-7335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. RAMLA OSMAN SAHID
Title or Position: PRESIDENT
Credential:
Phone: 619-727-7335