Provider Demographics
NPI:1396808499
Name:OAS, LLC
Entity type:Organization
Organization Name:OAS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-222-5201
Mailing Address - Street 1:23 UPPER PLN
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05033-9016
Mailing Address - Country:US
Mailing Address - Phone:802-222-5201
Mailing Address - Fax:802-222-5901
Practice Address - Street 1:23 UPPER PLN
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:VT
Practice Address - Zip Code:05033-9016
Practice Address - Country:US
Practice Address - Phone:802-222-5201
Practice Address - Fax:802-222-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0540324500000X
VT3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010872Medicaid