Provider Demographics
NPI:1811476971
Name:OCEAN VALLEY BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:OCEAN VALLEY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LAADC
Authorized Official - Phone:949-274-6920
Mailing Address - Street 1:PO BOX 1237
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-1237
Mailing Address - Country:US
Mailing Address - Phone:949-274-6920
Mailing Address - Fax:
Practice Address - Street 1:13961 MAUVE DR
Practice Address - Street 2:
Practice Address - City:NORTH TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92705-2649
Practice Address - Country:US
Practice Address - Phone:949-274-6920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility