Elim Pacific Ministries

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

66--0099 Issued in GU

Legal business name

ELIM PACIFIC MINISTRIES

Doing business as

Oasis Empowerment Center

Practice address

556 E Marine Corps Dr
Hagatna, GU 96910-5186

Phone

(671) 646-4601

Fax

(671) 646-5601

NPI assigned

Apr 23, 2012

Last updated

Apr 23, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert John Zimmerman, CSAC

Title

Executive Director

Phone

(671) 646-4601

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Oasis Empowerment Center Doing business as

Tax ID family

Elim Pacific Ministries2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Elim Pacific Ministries

  dba Oasis Empowerment Center

  • Substance Abuse Rehabilitation Facility
  • Hagatna, GU
  • NPI 1740570795
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1750648283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 E MARINE CORPS DR",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969105186",
            "telephone_number": "671-646-4601",
            "fax_number": "671-646-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 E MARINE CORPS DR",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "969105186",
            "telephone_number": "671-646-4601",
            "fax_number": "671-646-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIM PACIFIC MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "16716464601",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CSAC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GU",
            "license": "D-14051",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "GU",
            "license": "D-14051",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "GU",
            "license": "66--0099",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "GU",
            "license": "1228019153",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OASIS1",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oasis Empowerment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lavina Terese Leon Guerrero Camacho, M.S., MFT-136
• Nadine Taijeron Cepeda, M.A.
• Dawn Lynette Copp, MFT
• Daniel A. Duenas, LCSW, MAC,
• Elim Pacific Ministries (Oasis Empowerment Center)
• Expresscare Health and Skin Center Inc.
• Sabrina Fletcher, FNP
• Robert Roy Gatewood, D.D.S., M.S., PERIOD
• Government of Guam (Guam Fire Department)
• Government of Guam Department of Administration

• Substance Abuse Rehabilitation Facility in Hagatna, GU
• Providers in Hagatna, GU by specialty
• Substance Abuse Rehabilitation Facility in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.