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General NPI Number Information
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NPI Number | 1043098601
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Entity Type | Organization
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Legal Business Name | THE OASIS OF PINE BLUFF, LLC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 7001 S HAZEL ST
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City | PINE BLUFF
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State | AR
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Zip | 71603-7833
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Country | US
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Telephone | 501-416-6785
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Fax |
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Provider Business Mailing Address
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Address Line | 650 S SHACKLEFORD RD STE 232
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3561
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Country | US
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Telephone | 501-416-6785
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Fax |
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Authorized Official
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Title or Position | CE)
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Name | MR. EDWARD J GARLAND
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Credential |
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Telephone | 501-416-6785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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