Provider Demographics
NPI:1720867682
Name:BLUE OASIS FAMILY SERVICES
Entity Type:Organization
Organization Name:BLUE OASIS FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:757-282-9659
Mailing Address - Street 1:41 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-2275
Mailing Address - Country:US
Mailing Address - Phone:757-282-9659
Mailing Address - Fax:
Practice Address - Street 1:41 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-2275
Practice Address - Country:US
Practice Address - Phone:757-282-9659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health