| Ocean Behavioral Healthcare Llc | |
|
310 E Broadway Ste 102 Louisville KY 40202-1745 | |
| (919) 332-8969 | |
| Not Available |
| Full Name | Ocean Behavioral Healthcare Llc |
|---|---|
| Speciality | Social Worker |
| Location | 310 E Broadway Ste 102, Louisville, Kentucky |
| Authorized Official Name and Position | Jason C Ocean (CEO) |
| Authorized Official Contact | 9199247584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ocean Behavioral Healthcare Llc 310 E Broadway Ste 102 Louisville KY 40202-1745 Ph: () - | Ocean Behavioral Healthcare Llc 310 E Broadway Ste 102 Louisville KY 40202-1745 Ph: (919) 332-8969 |
| NPI Number | 1821637125 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 11/30/2020 |
| Certification Date | 11/30/2020 |
| Medicare PECOS PAC ID | 9032549969 |
|---|---|
| Medicare Enrollment ID | O20200416003515 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821637125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Jason C Ocean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992108658 PECOS PAC ID: 4587094412 Enrollment ID: I20200416003586 |
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