Healthcare Provider Details

I. General information

NPI: 1326221029
Provider Name (Legal Business Name): AN OASIS OF HEALING, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N CENTER ST SUITE 102
MESA AZ
85201-6600
US

IV. Provider business mailing address

210 N CENTER ST SUITE 102
MESA AZ
85201-6600
US

V. Phone/Fax

Practice location:
  • Phone: 480-834-5414
  • Fax: 480-834-5418
Mailing address:
  • Phone: 480-834-5414
  • Fax: 480-834-5418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLOTHILDE ELIZABETH CANALE
Title or Position: OFFICE MANAGER
Credential:
Phone: 480-834-5414