Healthcare Provider Details
I. General information
NPI: 1487444238
Provider Name (Legal Business Name): CO-LIVING OASIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
141 ARCOLA CT
HENDERSON NV
89015-1744
US
IV. Provider business mailing address
7911 SATINY CT
N LAS VEGAS NV
89084-4926
US
V. Phone/Fax
- Phone: 702-323-4077
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NESHELE
WRIGHT
Title or Position: ADMIN
Credential:
Phone: 702-323-4077