Provider Demographics
NPI:1336906684
Name:THE OASIS FOR HEALING LLC
Entity Type:Organization
Organization Name:THE OASIS FOR HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:WINEMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:507-269-9391
Mailing Address - Street 1:1160 LAPORTE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2422
Mailing Address - Country:US
Mailing Address - Phone:507-269-9391
Mailing Address - Fax:970-821-8466
Practice Address - Street 1:1160 LAPORTE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2422
Practice Address - Country:US
Practice Address - Phone:507-269-9391
Practice Address - Fax:970-821-8466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000177218Medicaid