Provider Demographics
NPI:1225322118
Name:OASIS HOME CARE
Entity Type:Organization
Organization Name:OASIS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MABLYN
Authorized Official - Middle Name:O
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-324-0535
Mailing Address - Street 1:5532 OLD NATIONAL HWY
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-3212
Mailing Address - Country:US
Mailing Address - Phone:404-324-0535
Mailing Address - Fax:404-209-9744
Practice Address - Street 1:5532 OLD NATIONAL HWY
Practice Address - Street 2:SUITE # 300
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-3212
Practice Address - Country:US
Practice Address - Phone:404-324-0535
Practice Address - Fax:404-209-9744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-0679251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health