Provider Demographics
NPI:1730966888
Name:OASIS PARADISE GROUP HOME
Entity type:Organization
Organization Name:OASIS PARADISE GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VERONA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOTE-JANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-279-3941
Mailing Address - Street 1:15782 63RD PL N
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3460
Mailing Address - Country:US
Mailing Address - Phone:954-279-3941
Mailing Address - Fax:
Practice Address - Street 1:15782 63RD PL N
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3460
Practice Address - Country:US
Practice Address - Phone:954-279-3941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services