Provider Demographics
NPI:1326846999
Name:MS THELMAS OASIS LLC
Entity type:Organization
Organization Name:MS THELMAS OASIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKEINA
Authorized Official - Middle Name:KEONTYE
Authorized Official - Last Name:CAMPBELL-BORDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-942-6178
Mailing Address - Street 1:1712 BURNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-3701
Mailing Address - Country:US
Mailing Address - Phone:443-942-6178
Mailing Address - Fax:
Practice Address - Street 1:1712 BURNWOOD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-3701
Practice Address - Country:US
Practice Address - Phone:443-942-6178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility