Healthcare Provider Details
I. General information
NPI: 1710838131
Provider Name (Legal Business Name): OLIVER OASIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22064 NOVI RD
NOVI MI
48375-4705
US
IV. Provider business mailing address
22064 NOVI RD
NOVI MI
48375-4705
US
V. Phone/Fax
- Phone: 248-383-5788
- Fax:
- Phone: 248-383-5788
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YUSHU
ZHOU
Title or Position: AUTHORISED REPRESENTATIVE
Credential:
Phone: 607-280-8808