Provider Demographics
NPI:1710391016
Name:OASIS OF ARKANSAS, INC
Entity Type:Organization
Organization Name:OASIS OF ARKANSAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CLARISE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:501-379-8617
Mailing Address - Street 1:301 MILLWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6319
Mailing Address - Country:US
Mailing Address - Phone:501-379-8617
Mailing Address - Fax:501-379-8617
Practice Address - Street 1:301 MILLWOOD CIR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-6319
Practice Address - Country:US
Practice Address - Phone:501-379-8617
Practice Address - Fax:501-379-8617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR155385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care