MEDICARE: OCEANSIDE SERVICES 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1659234375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANSIDE SERVICES LLC

Provider Business Mailing Address
First Line	:	8401 HOLLY RD STE 2
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1978
Country	:	US
Telephone Number	:	989-780-2598
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 HOLLY RD STE 2
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1978
Country	:	US
Telephone Number	:	989-780-2598
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	EMILY READ
Credential	:
Telephone Number	:	248-804-8024

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “OCEANSIDE SERVICES LLC ” Practice Location

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