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General NPI Number Information
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NPI Number | 1801680947
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Entity Type | Organization
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Legal Business Name | MENTAL OASIS LLC
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 6 W PARK AVE UNIT 1363
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City | LAKE WALES
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State | FL
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Zip | 33859-6257
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Country | US
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Telephone | 352-593-3853
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Fax |
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Provider Business Mailing Address
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Address Line | 6 W PARK AVE UNIT 1363
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City | LAKE WALES
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State | FL
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Zip | 33859-6257
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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 | EMPLOYEE
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Name | L C. RIVERA
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Credential |
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Telephone | 352-593-3853
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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 | 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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