Provider Demographics
NPI:1972077097
Name:BOIJJ OASIS LIVING
Entity type:Organization
Organization Name:BOIJJ OASIS LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAMILTON
Authorized Official - Middle Name:NAGBE
Authorized Official - Last Name:GMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-979-4359
Mailing Address - Street 1:10311 TEXAS SAGE WAY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6453
Mailing Address - Country:US
Mailing Address - Phone:281-979-4359
Mailing Address - Fax:
Practice Address - Street 1:10311 TEXAS SAGE WAY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6453
Practice Address - Country:US
Practice Address - Phone:281-979-4359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility