Provider Demographics
NPI:1699160200
Name:OASIS WELLNESS GROUP, INC.
Entity type:Organization
Organization Name:OASIS WELLNESS GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLOTA ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-987-6174
Mailing Address - Street 1:4958 S RAINBOW BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1418
Mailing Address - Country:US
Mailing Address - Phone:702-987-6174
Mailing Address - Fax:702-253-1468
Practice Address - Street 1:4958 S RAINBOW BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1418
Practice Address - Country:US
Practice Address - Phone:702-987-6174
Practice Address - Fax:702-253-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11918261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health