Provider Demographics
NPI:1336481563
Name:OASIS UNITED TRANSFORMATION COMMUNITY DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:OASIS UNITED TRANSFORMATION COMMUNITY DEVELOPMENT CORPORATION
Other - Org Name:OASIS CARE TCM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBREITA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-461-8685
Mailing Address - Street 1:3404 N ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-3411
Mailing Address - Country:US
Mailing Address - Phone:407-730-6977
Mailing Address - Fax:407-730-6978
Practice Address - Street 1:3404 N ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-3411
Practice Address - Country:US
Practice Address - Phone:407-730-6977
Practice Address - Fax:407-730-6978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management