Provider Demographics
NPI:1679089106
Name:OASIS BEHAVIORAL HEALTH & ADDICTION SERVICES
Entity type:Organization
Organization Name:OASIS BEHAVIORAL HEALTH & ADDICTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-320-5320
Mailing Address - Street 1:73 VALLEY RD FL 2
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2210
Mailing Address - Country:US
Mailing Address - Phone:732-484-1615
Mailing Address - Fax:732-879-0380
Practice Address - Street 1:73 VALLEY RD FL 2
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2210
Practice Address - Country:US
Practice Address - Phone:908-320-5320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00267600101YA0400X
NJ44SL06310800104100000X
1041C0700X, 261QM1300X
NJ26NJ00302100363LF0000X
NJ363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty