Provider Demographics
NPI:1376991356
Name:OASIS PAVILION NURSING & REHABILITATION CENTER
Entity Type:Organization
Organization Name:OASIS PAVILION NURSING & REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GRETA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:SWASEY-HADLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:520-836-1772
Mailing Address - Street 1:161 W RODEO RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6201
Mailing Address - Country:US
Mailing Address - Phone:520-836-1772
Mailing Address - Fax:520-421-4966
Practice Address - Street 1:161 W RODEO RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6201
Practice Address - Country:US
Practice Address - Phone:520-836-1772
Practice Address - Fax:520-421-4966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5191310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility