Healthcare Provider Details

I. General information

NPI: 1699160200
Provider Name (Legal Business Name): OASIS WELLNESS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4958 S RAINBOW BLVD SUITE 100
LAS VEGAS NV
89118-1418
US

IV. Provider business mailing address

4958 S RAINBOW BLVD SUITE 100
LAS VEGAS NV
89118-1418
US

V. Phone/Fax

Practice location:
  • Phone: 702-987-6174
  • Fax: 702-253-1468
Mailing address:
  • Phone: 702-987-6174
  • Fax: 702-253-1468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number11918
License Number StateNV

VIII. Authorized Official

Name: ROSA BELLOTA ROJAS
Title or Position: CO-CHAIRMAN
Credential: M.D.
Phone: 702-987-6174