Healthcare Provider Details

I. General information

NPI: 1366358368
Provider Name (Legal Business Name): LITTLE OASIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4912 VALLERY PL
RALEIGH NC
27604-6518
US

IV. Provider business mailing address

4912 VALLERY PL
RALEIGH NC
27604-6518
US

V. Phone/Fax

Practice location:
  • Phone: 919-699-2805
  • Fax: 919-882-1164
Mailing address:
  • Phone: 919-699-2805
  • Fax: 919-882-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LILIAN G NGANGA
Title or Position: OWNER
Credential: RN, BSN,
Phone: 919-699-2805