Provider Demographics
NPI:1093350357
Name:OASIS MENTAL HEALTH CENTER LLC
Entity type:Organization
Organization Name:OASIS MENTAL HEALTH CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEIVY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVO HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-418-9790
Mailing Address - Street 1:5901 NW 183RD ST STE 264
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6026
Mailing Address - Country:US
Mailing Address - Phone:786-418-9790
Mailing Address - Fax:786-358-6063
Practice Address - Street 1:5901 NW 183RD ST STE 264
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6026
Practice Address - Country:US
Practice Address - Phone:786-418-9790
Practice Address - Fax:786-358-6063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104765400Medicaid
FL116693800Medicaid
FL107090600Medicaid