Healthcare Provider Details

I. General information

NPI: 1386353480
Provider Name (Legal Business Name): OASIS OF JOY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 PRUDENTIAL RD
WORCESTER MA
01606-1578
US

IV. Provider business mailing address

79 PRUDENTIAL RD
WORCESTER MA
01606-1578
US

V. Phone/Fax

Practice location:
  • Phone: 774-329-7211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL MINGI
Title or Position: DIRECTOR
Credential:
Phone: 774-329-7211