Provider Demographics
NPI:1710298450
Name:OASIS GROUP, LLC
Entity Type:Organization
Organization Name:OASIS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:908-484-7354
Mailing Address - Street 1:PO BOX 132
Mailing Address - Street 2:3640 VALLEY RD
Mailing Address - City:LIBERTY CORNER
Mailing Address - State:NJ
Mailing Address - Zip Code:07938-0132
Mailing Address - Country:US
Mailing Address - Phone:908-484-7354
Mailing Address - Fax:973-912-9050
Practice Address - Street 1:3640 VALLEY RD
Practice Address - Street 2:
Practice Address - City:LIBERTY CORNER
Practice Address - State:NJ
Practice Address - Zip Code:07938
Practice Address - Country:US
Practice Address - Phone:908-484-7354
Practice Address - Fax:973-912-9050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00308900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty