Provider Demographics
NPI:1881675809
Name:OASIS HOME CARE, INC.
Entity Type:Organization
Organization Name:OASIS HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ISA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-687-2755
Mailing Address - Street 1:1511 PROSPERITY FARMS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-2046
Mailing Address - Country:US
Mailing Address - Phone:561-687-2755
Mailing Address - Fax:561-687-8323
Practice Address - Street 1:1511 PROSPERITY FARMS RD, STE 300
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403
Practice Address - Country:US
Practice Address - Phone:561-687-2755
Practice Address - Fax:561-687-8323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA299991332251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL028141700Medicaid
FL028141700Medicaid