MEDICARE: OASIS OF NEW HMAPSHIRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1457192940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS OF NEW HMAPSHIRE

Provider Business Mailing Address
First Line	:	923 ELM ST UNIT 94
Second Line	:
City	:	MANCHESTER
State	:	NH
Zip	:	03101-2003
Country	:	US
Telephone Number	:	617-818-5253
Fax Number	:

Provider Business Practice Location Address
First Line	:	598 FOREST RD
Second Line	:
City	:	GREENFIELD
State	:	NH
Zip	:	03047-4510
Country	:	US
Telephone Number	:	617-818-5253
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	CHANCE BOAZ
Credential	:
Telephone Number	:	617-818-5235

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	06/06/2024

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Directions to “OASIS OF NEW HMAPSHIRE ” Practice Location

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