Healthcare Provider Details

I. General information

NPI: 1043188410
Provider Name (Legal Business Name): OASIS HEART
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 W WILLOW DALE DR
KUNA ID
83634-1080
US

IV. Provider business mailing address

279 W WILLOW DALE DR
KUNA ID
83634-1080
US

V. Phone/Fax

Practice location:
  • Phone: 208-800-8096
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: EDOZIE AGBUNNORH
Title or Position: OWNER
Credential:
Phone: 281-965-5757