Healthcare Provider Details

I. General information

NPI: 1265606388
Provider Name (Legal Business Name): OASIS CLINICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 COMMERCE PLACE 4TH FLOOR
ELIZABETH NJ
07201
US

IV. Provider business mailing address

208 COMMERCE PLACE 4TH FLOOR
ELIZABETH NJ
07201
US

V. Phone/Fax

Practice location:
  • Phone: 908-372-3000
  • Fax: 908-372-3009
Mailing address:
  • Phone: 908-372-3000
  • Fax: 908-372-3009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2000191
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number10161-01-05
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number2000191
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number2000191
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. CARL F SCHULZ
Title or Position: BUSINESS DIRECTOR/OWNER
Credential:
Phone: 908-372-3000