Provider Demographics
NPI:1396141123
Name:OASIS COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:OASIS COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLENSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-610-3644
Mailing Address - Street 1:351 N AIR DEPOT BLVD STE M
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-1760
Mailing Address - Country:US
Mailing Address - Phone:405-610-3644
Mailing Address - Fax:
Practice Address - Street 1:351 N AIR DEPOT BLVD STE M
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-1760
Practice Address - Country:US
Practice Address - Phone:405-610-3644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicaid