Organization
OASIS RESIDENTIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAZIE GRAHAM (ADMINISTRATOR)
(843) 527-4848
Entity
Organization
Contact information
Practice address
2317 PRINCE ST, GEORGETOWN, SC 29440-2925
(843) 527-4848
Mailing address
2317 PRINCE ST, GEORGETOWN, SC 29440-2925
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
CRC1219
SC
Other
Enumeration date
07/03/2007
Last updated
08/22/2020
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