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General NPI Number Information
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NPI Number | 1477444842
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Entity Type | Organization
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Legal Business Name | SPRING CREEK OASIS
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 13800 HEACOCK ST STE C234
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3364
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Country | US
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Telephone | 323-816-2755
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Fax | 877-341-4477
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Provider Business Mailing Address
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Address Line | 13800 HEACOCK ST STE C234
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3364
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Country | US
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Telephone | 323-816-2755
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Fax | 877-341-4477
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Authorized Official
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Title or Position | ADMINISTRATOR/DIRECTOR
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Name | CHARLES STEWART
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Credential |
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Telephone | 323-816-2755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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