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General NPI Number Information
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NPI Number | 1508702713
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Entity Type | Organization
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Legal Business Name | OASIS RECOVERY HOME LLC
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 4299 CARTEGENA WAY
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City | LAS VEGAS
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State | NV
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Zip | 89121-6501
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Country | US
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Telephone | 702-416-4196
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Fax |
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Provider Business Mailing Address
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Address Line | 4023 WEYBRIDGE DR
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City | LAS VEGAS
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State | NV
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Zip | 89121-4847
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Country | US
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Telephone | 702-416-4196
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT WALCOM
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Credential |
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Telephone | 702-416-4196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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