| Oasis Pch Llc | |
|
1487 Panola Rd Stone Mountain GA 30088-3305 | |
| (770) 573-1076 | |
| Not Available |
| Full Name | Oasis Pch Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1487 Panola Rd, Stone Mountain, Georgia |
| Authorized Official Name and Position | Patrick Gordon (COO) |
| Authorized Official Contact | 4044322350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oasis Pch Llc 1227 Rockbridge Rd Ste 208-196 Stone Mountain GA 30087-3064 Ph: (770) 755-1394 | Oasis Pch Llc 1487 Panola Rd Stone Mountain GA 30088-3305 Ph: (770) 573-1076 |
| NPI Number | 1649844507 |
|---|---|
| Provider Enumeration Date | 05/16/2021 |
| Last Update Date | 05/16/2021 |
| Certification Date | 05/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649844507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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