Basic Information
| Provider Information | |||||||||
| NPI: | 1396141123 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | OASIS COUNSELING CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 351 N AIR DEPOT BLVD STE M | ||||||||
| Address2: | |||||||||
| City: | MIDWEST CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731101760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056103644 | ||||||||
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| Practice Location | |||||||||
| Address1: | 351 N AIR DEPOT BLVD STE M | ||||||||
| Address2: | |||||||||
| City: | MIDWEST CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731101760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056103644 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2014 | ||||||||
| LastUpdateDate: | 11/05/2014 | ||||||||
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| AuthorizedOfficialLastName: | ALLENSWORTH | ||||||||
| AuthorizedOfficialFirstName: | DONNIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4056103644 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | OK | Y | Agencies | Community/Behavioral Health |
No ID Information.