Healthcare Provider Details

I. General information

NPI: 1285367383
Provider Name (Legal Business Name): OASIS REHABILITATION & HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CASTLEMAIN CIR
DAVENPORT FL
33897-0522
US

IV. Provider business mailing address

115 CASTLEMAIN CIR
DAVENPORT FL
33897-0522
US

V. Phone/Fax

Practice location:
  • Phone: 352-474-8519
  • Fax:
Mailing address:
  • Phone: 352-474-8519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: NATALIE SMALL JOHNSON
Title or Position: OWNER
Credential:
Phone: 352-474-8519