Provider Demographics
NPI:1295132033
Name:OASIS PALMS INC
Entity type:Organization
Organization Name:OASIS PALMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-338-0014
Mailing Address - Street 1:12629 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2612
Mailing Address - Country:US
Mailing Address - Phone:754-210-6790
Mailing Address - Fax:
Practice Address - Street 1:12629 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-2612
Practice Address - Country:US
Practice Address - Phone:754-210-6790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OASIS PALMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-21
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12566310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility