Provider Demographics
NPI:1639804057
Name:OASIS OF TENDER CARE LLC
Entity Type:Organization
Organization Name:OASIS OF TENDER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COOWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-693-9540
Mailing Address - Street 1:2004 172ND ST E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-7629
Mailing Address - Country:US
Mailing Address - Phone:301-693-9540
Mailing Address - Fax:
Practice Address - Street 1:2004 172ND ST E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-7629
Practice Address - Country:US
Practice Address - Phone:301-693-9540
Practice Address - Fax:253-503-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home