Healthcare Provider Details

I. General information

NPI: 1598487225
Provider Name (Legal Business Name): OASIS HOUSE FOR HEALING AND RESTORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 09/19/2022
Certification Date: 09/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4831 DARROW RD
STOW OH
44224-1409
US

IV. Provider business mailing address

68 RAVENNA ST UNIT 667
HUDSON OH
44236-6419
US

V. Phone/Fax

Practice location:
  • Phone: 234-233-5249
  • Fax:
Mailing address:
  • Phone: 234-233-5249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MS. DANIELLE WRIGHT
Title or Position: FOUNDER
Credential:
Phone: 234-233-5249