Organization
THE OASIS HOME II LLC
Active
Parent organization
THE OASIS HOME LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE OASIS HOME LLC
Authorized official
MR. EMMANUEL MOUNKAM (ADMINISTRATOR)
(520) 270-7055
Entity
Organization
Contact information
Practice address
845 W CALLE BARBITAS, SAHUARITA, AZ 85629-7907
(520) 777-5215
(520) 777-6391
Mailing address
11124 W DENIER DR, MARANA, AZ 85653-8270
(520) 270-7055
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH-4044
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182785
AHCCCS ID NUMBER
AZ
Enumeration date
06/28/2012
Last updated
06/28/2012
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