AMAZING GRACE OASIS NPI 1629585856

NPI Information

AMAZING GRACE OASIS is an intermediate care facility mentally retarded in Hesperia, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. AMAZING GRACE OASIS NPI is 1629585856. The provider is registered as an organization entity type.

The provider's business location address is:

13842 LEMONGRASS WAY
HESPERIA, CA
ZIP 92344-042
Phone: (818) 572-3956
Fax: (760) 983-5616

The provider's authorized official is Eileen Andreasyan .
The authorized official title is Administrator and has the following contact phone number (818) 572-3956.

The CLIA number assigned to this NPI record is 05D2136671 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/9/2018 and was last updated on 1/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.