Organization
OASIS VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BERTHA MCCOY (PRESIDENT OWNER)
(817) 535-3388
Entity
Organization
Contact information
Practice address
2740 AVENUE K, FORT WORTH, TX 76105-3001
(817) 535-3388
(817) 534-8833
Mailing address
2740 AVENUE K, FORT WORTH, TX 76105-3001
(817) 535-3388
(817) 534-8833
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
120231
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120231
STAE LICENSE
TX
Enumeration date
06/04/2007
Last updated
08/22/2020
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