Provider Demographics
NPI:1780861500
Name:OASIS BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:OASIS BEHAVIORAL HEALTH, INC.
Other - Org Name:OASIS COMMUNITY SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT AND CHIEF EXECUTIVE OFFIC
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-221-6336
Mailing Address - Street 1:81557 DOCTOR CARREON BLVD.
Mailing Address - Street 2:SUITE C-8 AND C-9
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5562
Mailing Address - Country:US
Mailing Address - Phone:760-391-6999
Mailing Address - Fax:
Practice Address - Street 1:81557 DOCTOR CARREON BLVD.
Practice Address - Street 2:SUITE C-8 AND C-9
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5562
Practice Address - Country:US
Practice Address - Phone:760-391-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OASIS REHABILITATION CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-23
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA09-00009098OtherCITY OF INDIO BIZ LICENSE