MEDICARE: OASIS OF HOPE RESIDENCE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

General Provider Information

NPI Number	:	1952259855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS OF HOPE RESIDENCE LLC

Provider Business Mailing Address
First Line	:	1332 DIPLOMAT PKWY W
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-4600
Country	:	US
Telephone Number	:
Fax Number	:	954-361-4333

Provider Business Practice Location Address
First Line	:	1332 DIPLOMAT PKWY W
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-4600
Country	:	US
Telephone Number	:	954-361-4333
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GEORGIA GREY
Credential	:
Telephone Number	:	239-703-3816

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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