Healthcare Provider Details

I. General information

NPI: 1639436918
Provider Name (Legal Business Name): OASIS BEHAVIORAL HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 PROVIDENCE HWY UNIT 25
NORWOOD MA
02062-4647
US

IV. Provider business mailing address

1506 PROVIDENCE HWY UNIT 25
NORWOOD MA
02062-4647
US

V. Phone/Fax

Practice location:
  • Phone: 617-401-7700
  • Fax: 617-299-8534
Mailing address:
  • Phone: 617-401-7700
  • Fax: 617-299-8534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number230794
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number230794
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number230794
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number230794
License Number StateMA

VIII. Authorized Official

Name: DR. MATHEWS THOMAS
Title or Position: DIRECTOR
Credential: M.D
Phone: 617-947-8897