MEDICARE: OCEANS BEHAVIORAL HOSPITAL OF BATON ROUGE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital	593	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437188505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANS BEHAVIORAL HOSPITAL OF BATON ROUGE LLC

Provider Business Mailing Address
First Line	:	3905 HEDGCOXE RD UNIT 250249
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-0840
Country	:	US
Telephone Number	:	972-464-0022
Fax Number	:	972-464-0021

Provider Business Practice Location Address
First Line	:	7855 HOWELL BLVD STE 100
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70807-5256
Country	:	US
Telephone Number	:	225-465-8104
Fax Number	:	225-465-8896

Authorized Official
Title or Position	:	C.E.O.
Name	:	MR. STUART ARCHER
Credential	:
Telephone Number	:	972-464-0022

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	01/04/2022

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