Provider Demographics
NPI:1699129189
Name:GALT OCEAN REHAB LLC
Entity type:Organization
Organization Name:GALT OCEAN REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-368-1345
Mailing Address - Street 1:4001 N OCEAN DR STE 305
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5968
Mailing Address - Country:US
Mailing Address - Phone:954-383-8449
Mailing Address - Fax:
Practice Address - Street 1:4001 N OCEAN DR STE 305
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5968
Practice Address - Country:US
Practice Address - Phone:844-468-1345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-20
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty