Provider Demographics
NPI:1679699169
Name:OASIS COUNSELING CENTER,INC.
Entity Type:Organization
Organization Name:OASIS COUNSELING CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:KAIL
Authorized Official - Last Name:ALLENSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:405-605-3093
Mailing Address - Street 1:PO BOX 57241
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73157-7241
Mailing Address - Country:US
Mailing Address - Phone:405-605-3093
Mailing Address - Fax:405-601-5682
Practice Address - Street 1:4911 N PORTLAND AVE
Practice Address - Street 2:111
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6170
Practice Address - Country:US
Practice Address - Phone:405-605-3093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200045660AMedicaid