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General NPI Number Information
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NPI Number | 1568355451
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Entity Type | Organization
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Legal Business Name | EAGLES OASIS
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 8754 E VIA DE ENCANTO
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4019
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Country | US
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Telephone | 602-705-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 1833 W LARK DR
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City | CHANDLER
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State | AZ
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Zip | 85286-7485
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Country | US
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Telephone | 602-705-1011
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Fax | 602-705-1011
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Authorized Official
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Title or Position | CEO
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Name | MYRIO M DAVIS
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Credential |
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Telephone | 602-705-1011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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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 | 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 #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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