MEDICARE: THE OASIS OF LOVE, INC.

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891849113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OASIS OF LOVE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 268
Second Line	:
City	:	ANALOMINK
State	:	PA
Zip	:	18320-0268
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	814 MONROE ST
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-1744
Country	:	US
Telephone Number	:	570-972-0838
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. FRANK MEDERO
Credential	:
Telephone Number	:	570-972-0838

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	04/17/2012

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Directions to “THE OASIS OF LOVE, INC. ” Practice Location

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