Provider Demographics
NPI:1972328318
Name:DORIS OASIS
Entity type:Organization
Organization Name:DORIS OASIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERMONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-682-9391
Mailing Address - Street 1:355 MARILYN DR
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84015-1037
Mailing Address - Country:US
Mailing Address - Phone:801-682-9391
Mailing Address - Fax:
Practice Address - Street 1:355 MARILYN DR
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:UT
Practice Address - Zip Code:84015-1037
Practice Address - Country:US
Practice Address - Phone:801-682-9391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities