Basic Information
| Provider Information | |||||||||
| NPI: | 1316377666 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OCEANS BEHAVIORAL HOSPITAL OF LONGVIEW LLC | ||||||||
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| OtherOrganizationName: | OCEANS BEHAVIORAL HOSPITAL OF LONGVIEW | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 LAKESHORE DR | ||||||||
| Address2: | STE 1000 | ||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706290100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3377211900 | ||||||||
| FaxNumber: | 3377211976 | ||||||||
| Practice Location | |||||||||
| Address1: | 615 CLINIC DR | ||||||||
| Address2: | |||||||||
| City: | LONGVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756055172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9032123105 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2013 | ||||||||
| LastUpdateDate: | 11/23/2013 | ||||||||
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| AuthorizedOfficialLastName: | REED | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | JASON | ||||||||
| AuthorizedOfficialTitleorPosition: | C.E.O. | ||||||||
| AuthorizedOfficialTelephone: | 3377211900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.