Basic Information
Provider Information
NPI: 1811580434
EntityType: 2
ReplacementNPI:  
OrganizationName: OCEANS BEHAVIORAL HOSPITAL OF CORPUS CHRISTI LLC
LastName:  
FirstName:  
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Credential:  
OtherOrganizationName: OCEANS BEHAVIORAL HOSPITAL OF CORPUS CHRISTI
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 3905 HEDGCOXE RD UNIT 250249
Address2:  
City: PLANO
State: TX
PostalCode: 750250840
CountryCode: US
TelephoneNumber: 9724640022
FaxNumber: 9724640021
Practice Location
Address1: 600 ELIZABETH ST
Address2: 5 EAST
City: CORPUS CHRISTI
State: TX
PostalCode: 784042235
CountryCode: US
TelephoneNumber: 5046458196
FaxNumber: 9724640021
Other Information
ProviderEnumerationDate: 02/15/2021
LastUpdateDate: 09/26/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: TARANTINO
AuthorizedOfficialFirstName: LAURA
AuthorizedOfficialMiddleName: F.
AuthorizedOfficialTitleorPosition: EVP
AuthorizedOfficialTelephone: 9853772219
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 09/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
283Q00000X  Y HospitalsPsychiatric Hospital 

No ID Information.


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