Healthcare Provider Details

I. General information

NPI: 1952672560
Provider Name (Legal Business Name): OASIS INDEPENDENT LIVING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 PENNSYLVANIA AVE
SAINT LOUIS MO
63130-2325
US

IV. Provider business mailing address

17868 ARGONNE ESTATES DR
FLORISSANT MO
63034-1334
US

V. Phone/Fax

Practice location:
  • Phone: 314-725-2868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. SHERMAN L STRONG
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 314-838-0744