Organization
OASIS LIFECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON M LIEB (EXECUTIVE OFFICER)
(814) 883-9949
Entity
Organization
Contact information
Practice address
1520 MARTIN ST, STATE COLLEGE, PA 16803-3058
(814) 883-9949
Mailing address
1520 MARTIN ST, STATE COLLEGE, PA 16803-3058
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
06/15/2015
Last updated
07/20/2015
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