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General NPI Number Information
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NPI Number | 1245721828
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Entity Type | Organization
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Legal Business Name | AGING OASIS LLC
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Dates
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Enumeration Date | 05/19/2018
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 2701 COTTAGE WAY STE 16
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City | SACRAMENTO
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State | CA
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Zip | 95825-1226
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Country | US
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Telephone | 916-306-0674
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Fax | 916-307-6374
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Provider Business Mailing Address
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Address Line | 2701 COTTAGE WAY STE 16
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City | SACRAMENTO
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State | CA
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Zip | 95825-1226
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Country | US
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Telephone | 163-060-6749
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Fax | 916-307-6374
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | KELLEY MCCALL
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Credential | SENIOR CARE ADVISOR
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Telephone | 916-306-0674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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