AMAZING GRACE OASIS II (NPI# 1396213302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396213302 |
| Entity Type | Organization |
| Organization Name | AMAZING GRACE OASIS II |
| Practice Address |
8708 Bridgeport Ave Hesperia CA 92344-5562 |
| Practice Telephone | 8185723956 |
| Practice Fax Number | 8189253011 |
| Mailing Telephone | 8185723956 |
| Mailing Fax Number | 8189253011 |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-11-07 |
| Authorized Official Name | EILEEN ANDREASYAN (ADMINISTRATOR) |
| Authorized Official Telephone | 8185723956 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities |
| Street Address |
8708 BRIDGEPORT AVE |
| City | HESPERIA |
| State | CA |
| Zip Code | 92344-5562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639246 | Carolyn Susan Shaw | Technician | 13312 Ranchero Rd #533, Oak Hills, CA 92344 | 2019-10-07 |
| 1821587684 | Joseph Mica Benavides | Licensed Practical Nurse | 6425 Columbine Rd., Oak Hills, CA 92344 | 2018-05-08 |
| 1841725280 | Ruben Sergio Padilla | Behavioral Analyst | 8794 Tustin Ave, Hesperia, CA 92344 | 2017-04-24 |
| 1184755233 | Virginia L Schwab | Counselor | 7657 Coleridge Road, Oak Hills, CA 92344 | 2007-03-08 |
| 1407347305 | Noel Norman Flowers Sr. | Driver | 13850 Rosemary St, Hesperia, CA 92344-0001 | 2018-05-25 |
| 1386015840 | Darin Saunders | Registered Nurse | 13842 Lemongrass Way, Hesperia, CA 92344-0042 | 2015-10-09 |
| 1629585856 | Amazing Grace Oasis | Intermediate Care Facility, Mentally Retarded | 13842 Lemongrass Way, Hesperia, CA 92344-0042 | 2018-01-09 |
| 1114572955 | Lighthouse Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 9184 Wild Horse Ave, Hesperia, CA 92344-0047 | 2019-08-08 |
| 1891212353 | Melissa Ann De Silva | Behavioral Analyst | 8546 Wagon Wheel Ct, Hesperia, CA 92344-0192 | 2017-08-25 |
| 1326695032 | Brooke A Palmer | Behavior Technician | 10720 Cedar St, Oak Hills, CA 92344-0660 | 2019-08-19 |
| Find all providers in zip 92344 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487282273 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 303 S C St, Lompoc, CA 93436-7305 | 2020-03-29 |
| 1497386569 | M&s Guesthomes, Inc. | Intermediate Care Facility, Mental Illness | 2424 W Glencrest Ave, Anaheim, CA 92801-3224 | 2020-01-28 |
| 1346711504 | Cedacal, LLC. | Intermediate Care Facility, Mental Illness | 5663 Cedarglen Dr, Azusa, CA 91702-5007 | 2018-12-16 |
| 1972081651 | Oc Care Centers, Inc. | Intermediate Care Facility, Mental Illness | 127 N Queensbury St, Anaheim, CA 92806-3814 | 2018-08-03 |
| 1659858868 | Athina Kamar | Intermediate Care Facility, Mental Illness | 5826 Jumilla Ave, Woodland Hills, CA 91367-5604 | 2018-07-20 |
| 1447758024 | Crestwood Behavioral Health Inc | Intermediate Care Facility, Mental Illness | 450 Stanyan St Fl 5, San Francisco, CA 94117-1019 | 2018-01-29 |
| 1376067439 | Alacar. Inc | Intermediate Care Facility, Mental Illness | 4640 E Kaviland Ave, Fresno, CA 93725-1632 | 2017-07-31 |
| 1912358904 | American Helath Services | Intermediate Care Facility, Mental Illness | 1524 W 227th St Apt 1, Torrance, CA 90501-4917 | 2016-06-30 |
| 1639547896 | Arcaida Home Care & Staffing | Intermediate Care Facility, Mental Illness | 1090 E Cypress Ave, Suite B, Redding, CA 96002-1163 | 2015-09-04 |
| 1023495181 | Crestwood Behavioral Health, Inc. | Intermediate Care Facility, Mental Illness | 960 Third Ave, Chula Vista, CA 91911 | 2015-04-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.