Provider Demographics
NPI:1710626155
Name:OASIS MENTAL HEALTH & NEUROPSYCHIATRY CLINIC
Entity type:Organization
Organization Name:OASIS MENTAL HEALTH & NEUROPSYCHIATRY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZEBULON
Authorized Official - Middle Name:
Authorized Official - Last Name:FOREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-401-6856
Mailing Address - Street 1:8309 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-6935
Mailing Address - Country:US
Mailing Address - Phone:678-401-6856
Mailing Address - Fax:
Practice Address - Street 1:3040 HIGHLANDS PKWY SE STE F
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5178
Practice Address - Country:US
Practice Address - Phone:678-401-6856
Practice Address - Fax:678-623-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)