Provider Demographics
NPI:1861906034
Name:OASIS PRIVATE HOME CARE SERVICES INC
Entity type:Organization
Organization Name:OASIS PRIVATE HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-592-4183
Mailing Address - Street 1:6340 ROBINS NEST
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-4976
Mailing Address - Country:US
Mailing Address - Phone:678-592-4183
Mailing Address - Fax:770-881-7503
Practice Address - Street 1:6340 ROBINS NEST
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-4976
Practice Address - Country:US
Practice Address - Phone:678-592-4183
Practice Address - Fax:770-881-7503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care