Provider Demographics
NPI:1366789919
Name:GRUPO TERAPEUTICO OASIS, INC.
Entity type:Organization
Organization Name:GRUPO TERAPEUTICO OASIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-632-1179
Mailing Address - Street 1:15422 CALLE FLAMBOYAN
Mailing Address - Street 2:PASEO JACARANDA
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757
Mailing Address - Country:US
Mailing Address - Phone:787-632-1179
Mailing Address - Fax:
Practice Address - Street 1:124 CALLE JOSE I QUINTON
Practice Address - Street 2:SUITE #7
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-2409
Practice Address - Country:US
Practice Address - Phone:787-632-1179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2158261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)