Provider Demographics
NPI:1821630302
Name:THERAPEUTIC OASIS OF THE TREASURE COAST LLC
Entity Type:Organization
Organization Name:THERAPEUTIC OASIS OF THE TREASURE COAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGGIANI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:561-278-6033
Mailing Address - Street 1:600 HERITAGE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-5288
Mailing Address - Country:US
Mailing Address - Phone:561-278-6033
Mailing Address - Fax:561-278-6023
Practice Address - Street 1:600 HERITAGE DR STE 130
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5288
Practice Address - Country:US
Practice Address - Phone:561-278-6033
Practice Address - Fax:561-278-6023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty