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General NPI Number Information
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NPI Number | 1710391016
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Entity Type | Organization
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Legal Business Name | OASIS OF ARKANSAS, INC
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Dates
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Enumeration Date | 06/13/2014
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Last Update Date | 06/13/2014
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Provider Practice Location Address
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Address Line | 301 MILLWOOD CIR
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City | MAUMELLE
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State | AR
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Zip | 72113-6319
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Country | US
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Telephone | 501-379-8617
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Fax | 501-379-8617
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Provider Business Mailing Address
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Address Line | 301 MILLWOOD CIR
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City | MAUMELLE
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State | AR
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Zip | 72113-6319
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Country | US
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Telephone | 501-379-8617
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Fax | 501-379-8617
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. CLARISE MICHELLE TATUM
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Credential | MA
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Telephone | 501-379-8617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 155
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License Number State | AR
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