| Oasis Behavioral Health & Addiction Services | |
|
73 Valley Rd Fl 2 Montclair NJ 07042-2210 | |
| (908) 320-5320 | |
| Not Available |
| Full Name | Oasis Behavioral Health & Addiction Services |
|---|---|
| Speciality | Social Worker |
| Location | 73 Valley Rd Fl 2, Montclair, New Jersey |
| Authorized Official Name and Position | Timothy Bracaglia (OWNER) |
| Authorized Official Contact | 9083205320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oasis Behavioral Health & Addiction Services 73 Valley Rd Fl 2 Montclair NJ 07042-2210 Ph: (732) 484-1615 | Oasis Behavioral Health & Addiction Services 73 Valley Rd Fl 2 Montclair NJ 07042-2210 Ph: (908) 320-5320 |
| NPI Number | 1679089106 |
|---|---|
| Provider Enumeration Date | 12/20/2017 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Medicare PECOS PAC ID | 6709147853 |
|---|---|
| Medicare Enrollment ID | O20180306001047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679089106 | NPI | - | NPPES |
| Provider Name | Grace E Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417264318 PECOS PAC ID: 4587840202 Enrollment ID: I20110513000579 |
| Provider Name | Les Linet |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528123288 PECOS PAC ID: 1658403746 Enrollment ID: I20161122000904 |
| Provider Name | Gloria Servakh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417455767 PECOS PAC ID: 6507106739 Enrollment ID: I20190325002354 |
| Provider Name | Taylor M Zembricki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265102727 PECOS PAC ID: 8527456920 Enrollment ID: I20211103001406 |
| Provider Name | Jessica M Wicki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578204350 PECOS PAC ID: 4587045158 Enrollment ID: I20220714001187 |
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