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General NPI Number Information
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NPI Number | 1720864796
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Entity Type | Organization
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Legal Business Name | WELLNESS OASIS INC
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 1700 S COLORADO ST
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City | GREENVILLE
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State | MS
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Zip | 38703-7275
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Country | US
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Telephone | 662-702-3499
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Fax | 662-702-3126
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Provider Business Mailing Address
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Address Line | 21 CHRISTY DR
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City | CLEVELAND
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State | MS
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Zip | 38732-8780
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Country | US
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Telephone | 662-719-1912
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MICHELLDA BRADSHAW
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Credential |
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Telephone | 662-719-1912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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