Provider Demographics
NPI:1134909112
Name:OASIS FAMILY CARE LLC
Entity type:Organization
Organization Name:OASIS FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAKIZIMANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-818-5235
Mailing Address - Street 1:129 SUFFOLK ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2631
Mailing Address - Country:US
Mailing Address - Phone:617-818-5235
Mailing Address - Fax:
Practice Address - Street 1:129 SUFFOLK ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-2631
Practice Address - Country:US
Practice Address - Phone:617-818-5235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities