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General NPI Number Information
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NPI Number | 1114189321
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Entity Type | Organization
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Legal Business Name | OASIS INDEPENDENT LIVING SERVICES
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Dates
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Enumeration Date | 06/28/2008
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Last Update Date | 06/28/2008
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Provider Practice Location Address
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Address Line | 2002 CHAMBERS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63136-4308
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Country | US
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Telephone | 314-869-2713
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Fax |
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Provider Business Mailing Address
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Address Line | 17868 ARGONNE ESTATES DR
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City | FLORISSANT
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State | MO
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Zip | 63034-1334
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. SHERMAN STRONG
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Credential |
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Telephone | 314-838-0744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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