Provider Demographics
NPI:1477859809
Name:STERLING OASIS CEDC
Entity Type:Organization
Organization Name:STERLING OASIS CEDC
Other - Org Name:LIGHTHOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-866-6679
Mailing Address - Street 1:1707 CLARKE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-0629
Mailing Address - Country:US
Mailing Address - Phone:214-785-7330
Mailing Address - Fax:
Practice Address - Street 1:1707 CLARKE SPRINGS DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-0629
Practice Address - Country:US
Practice Address - Phone:214-785-7330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility