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General NPI Number Information
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NPI Number | 1932703667
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Entity Type | Organization
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Legal Business Name | GRACE'S OASIS LLC
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 15017 WINDMILL CIR
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City | CARMEL
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State | IN
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Zip | 46033-9075
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Country | US
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Telephone | 317-409-6977
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Fax |
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Provider Business Mailing Address
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Address Line | 15017 WINDMILL CIR
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City | CARMEL
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State | IN
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Zip | 46033-9075
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Country | US
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Telephone | 317-409-6977
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MAUREEN PONTO
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Credential |
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Telephone | 317-409-6977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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