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General NPI Number Information
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NPI Number | 1336948405
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Entity Type | Organization
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Legal Business Name | OASIS PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 2001 COUNTY ROAD 202
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City | LANETT
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State | AL
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Zip | 36863
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Country | US
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Telephone | 706-590-8188
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Fax |
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Provider Business Mailing Address
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Address Line | 120 19TH STREET SUITE 201 PMB 444522
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City | BIRMINGHAM
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State | AL
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Zip | 35203
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Country | US
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Telephone | 706-590-8188
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HEATHER BENSON CROWDER-KALLA
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Credential | PMHNP-BC
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Telephone | 706-590-8188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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