Healthcare Provider Details
I. General information
NPI: 1558013029
Provider Name (Legal Business Name): OASIS ADULT DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7400 UNIVERSITY AVE NE STE 125
FRIDLEY MN
55432-2224
US
IV. Provider business mailing address
7400 UNIVERSITY AVE NE STE 125
FRIDLEY MN
55432-2224
US
V. Phone/Fax
- Phone: 612-701-6720
- Fax:
- Phone: 612-701-6720
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FARHIA
SHIER
Title or Position: CENTER DIRECTOR
Credential:
Phone: 612-701-6720