| Oasis Behavioral Health, Llc | |
|
2261 Sharondale Dr Villa Rica GA 30180-8425 | |
| (678) 410-7304 | |
| Not Available |
| Full Name | Oasis Behavioral Health, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2261 Sharondale Dr, Villa Rica, Georgia |
| Authorized Official Name and Position | Angela Lester (OWNER) |
| Authorized Official Contact | 6784107304 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oasis Behavioral Health, Llc 2261 Sharondale Dr Villa Rica GA 30180-8425 Ph: (678) 410-7304 | Oasis Behavioral Health, Llc 2261 Sharondale Dr Villa Rica GA 30180-8425 Ph: (678) 410-7304 |
| NPI Number | 1295301174 |
|---|---|
| Provider Enumeration Date | 06/01/2021 |
| Last Update Date | 06/01/2021 |
| Certification Date | 06/01/2021 |
| Medicare PECOS PAC ID | 9638555766 |
|---|---|
| Medicare Enrollment ID | O20220927003164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295301174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela Lester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255977252 PECOS PAC ID: 7214310879 Enrollment ID: I20220815000346 |
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