Provider Demographics
NPI:1649693664
Name:PERRIS OASIS, INCORPORATED
Entity type:Organization
Organization Name:PERRIS OASIS, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:HINDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:310-837-9324
Mailing Address - Street 1:PO BOX 341310
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-9310
Mailing Address - Country:US
Mailing Address - Phone:310-893-9324
Mailing Address - Fax:
Practice Address - Street 1:21222 DAWES ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-9069
Practice Address - Country:US
Practice Address - Phone:951-943-2304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA330907269323P00000X
320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility