Provider Demographics
NPI:1922481191
Name:OASIS MINISTRIES LLC
Entity Type:Organization
Organization Name:OASIS MINISTRIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORAL
Authorized Official - Middle Name:KAZEBEE
Authorized Official - Last Name:TRINIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC007357
Authorized Official - Phone:470-336-8598
Mailing Address - Street 1:4562 LAWRENCEVILLE HWY NW STE 101B
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3650
Mailing Address - Country:US
Mailing Address - Phone:678-630-7564
Mailing Address - Fax:678-559-0717
Practice Address - Street 1:4562 LAWRENCEVILLE HWY NW STE 101B
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3650
Practice Address - Country:US
Practice Address - Phone:678-630-7564
Practice Address - Fax:687-559-0717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007357251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health