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Organization

STAR CITY DREAM OASIS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DERRICK ALEXANDER RUBEN QMHP (CEO)
(540) 797-8096
Entity
Organization

Contact information

Practice address
1402 WELLSLEY ST NW, ROANOKE, VA 24017-3032
(540) 797-8096
(540) 265-0986
Mailing address
1402 WELLSLEY ST NW, ROANOKE, VA 24017-3032
(540) 797-8096
(540) 265-0986

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary

Other

Enumeration date
07/30/2026
Last updated
07/30/2026
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