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General NPI Number Information
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NPI Number | 1457192940
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Entity Type | Organization
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Legal Business Name | OASIS OF NEW HMAPSHIRE
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 598 FOREST RD
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City | GREENFIELD
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State | NH
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Zip | 03047-4510
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Country | US
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Telephone | 617-818-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 923 ELM ST UNIT 94
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City | MANCHESTER
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State | NH
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Zip | 03101-2003
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Country | US
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Telephone | 617-818-5253
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | CHANCE BOAZ
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Credential |
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Telephone | 617-818-5235
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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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