Healthcare Provider Details

I. General information

NPI: 1457192940
Provider Name (Legal Business Name): OASIS OF NEW HMAPSHIRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 FOREST RD
GREENFIELD NH
03047-4510
US

IV. Provider business mailing address

923 ELM ST UNIT 94
MANCHESTER NH
03101-2003
US

V. Phone/Fax

Practice location:
  • Phone: 617-818-5253
  • Fax:
Mailing address:
  • Phone: 617-818-5253
  • 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: CHANCE BOAZ
Title or Position: CO-FOUNDER
Credential:
Phone: 617-818-5235