Healthcare Provider Details

I. General information

NPI: 1902686355
Provider Name (Legal Business Name): BECKYS OASIS SENIOR LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 FELDMEN DR
RALEIGH NC
27603-2018
US

IV. Provider business mailing address

1009 FELDMEN DR
RALEIGH NC
27603-2018
US

V. Phone/Fax

Practice location:
  • Phone: 919-906-5654
  • Fax:
Mailing address:
  • Phone: 919-906-5654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: BECKY OLIVIA EPELLE
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 919-906-5654