Provider Demographics
NPI:1043098601
Name:THE OASIS OF PINE BLUFF, LLC
Entity type:Organization
Organization Name:THE OASIS OF PINE BLUFF, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CE)
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-416-6785
Mailing Address - Street 1:650 S SHACKLEFORD RD STE 232
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3561
Mailing Address - Country:US
Mailing Address - Phone:501-416-6785
Mailing Address - Fax:
Practice Address - Street 1:7001 S HAZEL ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7833
Practice Address - Country:US
Practice Address - Phone:501-416-6785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility