# OASIS PAVILION NURSING AND REHABILITATION CENTER LLC-OTC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275901175
- **Authorized official:** MR. KENNETH U OPARA (ADMINISTRATOR)
- **Authorized official phone:** (520) 836-1772

## Contact information

- **Practice address:** 161 W RODEO RD, CASA GRANDE, AZ 85122-6201
- **Practice address phone:** (520) 836-1772
- **Practice address fax:** (520) 421-4966
- **Mailing address:** 161 W RODEO RD, CASA GRANDE, AZ 85122-6201
- **Mailing address phone:** (520) 836-1772
- **Mailing address fax:** (520) 421-4966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NCI-2692 | AZ | Yes |

## Other

- **Enumeration date:** 09/09/2015
- **Last updated:** 09/09/2015