Provider Demographics
NPI:1104591452
Name:OCEAN CITY SPECIALIZED RESIDENTIAL SERVICES
Entity type:Organization
Organization Name:OCEAN CITY SPECIALIZED RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEHINDE
Authorized Official - Middle Name:O
Authorized Official - Last Name:OGUNDIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-250-6576
Mailing Address - Street 1:50831 DENALI CT
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-2566
Mailing Address - Country:US
Mailing Address - Phone:214-250-6576
Mailing Address - Fax:
Practice Address - Street 1:50831 DENALI CT
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-2566
Practice Address - Country:US
Practice Address - Phone:214-250-6576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness