Healthcare Provider Details

I. General information

NPI: 1053228080
Provider Name (Legal Business Name): OASIS SUPPORTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 W 9TH ST APT 2407
LOS ANGELES CA
90015-1991
US

IV. Provider business mailing address

705 W 9TH ST APT 2407
LOS ANGELES CA
90015-1991
US

V. Phone/Fax

Practice location:
  • Phone: 323-649-2232
  • Fax:
Mailing address:
  • Phone: 323-649-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: OBINNA NNAH
Title or Position: DR. OBINNA NNAH
Credential:
Phone: 323-649-2232