Provider Demographics
NPI:1609553650
Name:OASIS THERAPY AND FARM LLC
Entity Type:Organization
Organization Name:OASIS THERAPY AND FARM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:WASZKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:321-307-3363
Mailing Address - Street 1:3200 MOCKINGBIRD AVE SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-4900
Mailing Address - Country:US
Mailing Address - Phone:321-307-3363
Mailing Address - Fax:
Practice Address - Street 1:3200 MOCKINGBIRD AVE SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-4900
Practice Address - Country:US
Practice Address - Phone:321-307-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty