| Champions Heart Oasis Llc | |
|
207 W Jefferson St Ste 311 Bloomington IL 61701-3969 | |
| (217) 828-0962 | |
| Not Available |
| Full Name | Champions Heart Oasis Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 207 W Jefferson St Ste 311, Bloomington, Illinois |
| Authorized Official Name and Position | Omolola Solape Lawal (MANAGER) |
| Authorized Official Contact | 2178280962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Champions Heart Oasis Llc 1762 Beech St Normal IL 61761-5622 Ph: (217) 828-0962 | Champions Heart Oasis Llc 207 W Jefferson St Ste 311 Bloomington IL 61701-3969 Ph: (217) 828-0962 |
| NPI Number | 1265227789 |
|---|---|
| Provider Enumeration Date | 04/14/2025 |
| Last Update Date | 04/14/2025 |
| Certification Date | 04/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265227789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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