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General NPI Number Information
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NPI Number | 1639410186
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Entity Type | Organization
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Legal Business Name | OASIS TOTAL DEVELOPMENT, INC.
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 8522 BROXBURN LN
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City | WAXHAW
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State | NC
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Zip | 28173
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Country | US
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Telephone | 704-488-5440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2053
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City | GARNER
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State | NC
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Zip | 27529-2053
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. MALACHI HAINES SR.
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Credential | JURIS DOCTOR
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Telephone | 704-845-8702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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