Provider Demographics
NPI:1902137664
Name:OCEAN MENTAL & BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:OCEAN MENTAL & BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DEVON
Authorized Official - Last Name:LEWELLYN
Authorized Official - Suffix:
Authorized Official - Credentials:FOUNDER
Authorized Official - Phone:702-807-9392
Mailing Address - Street 1:8871 W FLAMINGO RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8728
Mailing Address - Country:US
Mailing Address - Phone:702-807-9392
Mailing Address - Fax:
Practice Address - Street 1:8871 W FLAMINGO RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8728
Practice Address - Country:US
Practice Address - Phone:702-807-9392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253J00000XAgenciesFoster Care Agency