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General NPI Number Information
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NPI Number | 1467749747
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Entity Type | Organization
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Legal Business Name | OASIS HOME CARE
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 07/07/2011
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Provider Practice Location Address
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Address Line | 5532 OLD NATIONAL HWY SUITE # 300
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City | COLLEGE PARK
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State | GA
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Zip | 30349-3212
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Country | US
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Telephone | 404-324-0535
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Fax |
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Provider Business Mailing Address
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Address Line | 5532 OLD NATIONAL HWY SUITE # 300
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City | COLLEGE PARK
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State | GA
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Zip | 30349-3212
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Country | US
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Telephone | 404-324-0535
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MABLYN O JACOBS
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Credential |
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Telephone | 404-324-0535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 060-R-0679
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License Number State | GA
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