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General NPI Number Information
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NPI Number | 1174921472
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Entity Type | Organization
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Legal Business Name | RECOVERY OASIS LLC
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Dates
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Enumeration Date | 12/18/2014
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 1208 E BROADWAY RD STE 215
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City | TEMPE
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State | AZ
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Zip | 85282-1512
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Country | US
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Telephone | 480-699-1233
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Fax | 480-907-7082
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Provider Business Mailing Address
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Address Line | 1208 E BROADWAY RD STE 215
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City | TEMPE
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State | AZ
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Zip | 85282-1512
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Country | US
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Telephone | 480-699-1233
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Fax | 480-907-7082
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Authorized Official
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Title or Position | CEO
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Name | MR. CHRISTOPHER VERNE MULLIN
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Credential | CDP
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Telephone | 480-699-1233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | AZ
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