Healthcare Provider Details

I. General information

NPI: 1154207348
Provider Name (Legal Business Name): OASIS PERSONAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 S EASTERN AVE
LAS VEGAS NV
89104-4109
US

IV. Provider business mailing address

2150 S EASTERN AVE
LAS VEGAS NV
89104-4109
US

V. Phone/Fax

Practice location:
  • Phone: 702-207-0842
  • Fax: 702-207-0357
Mailing address:
  • Phone: 702-207-0842
  • Fax: 702-207-0357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LUIS GUILLERMO RODRIGUEZ LABRADA
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-207-0842