Provider Demographics
NPI:1467010264
Name:AGING OASIS LLC
Entity Type:Organization
Organization Name:AGING OASIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:SENIOR CARE ADVISOR
Authorized Official - Phone:916-993-9387
Mailing Address - Street 1:2701 COTTAGE WAY STE 16
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-1226
Mailing Address - Country:US
Mailing Address - Phone:916-993-9387
Mailing Address - Fax:916-993-9127
Practice Address - Street 1:2701 COTTAGE WAY STE 16
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-1226
Practice Address - Country:US
Practice Address - Phone:916-993-9387
Practice Address - Fax:916-993-9127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty