Provider Demographics
NPI:1285416230
Name:SOLACE CARE OASIS LLC
Entity type:Organization
Organization Name:SOLACE CARE OASIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:239-822-0823
Mailing Address - Street 1:1441 GOLDEN GLOW DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-5465
Mailing Address - Country:US
Mailing Address - Phone:239-822-0823
Mailing Address - Fax:
Practice Address - Street 1:4920 W CYPRESS ST STE 104
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-3837
Practice Address - Country:US
Practice Address - Phone:239-822-0823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing CareGroup - Single Specialty