Healthcare Provider Details

I. General information

NPI: 1558657809
Provider Name (Legal Business Name): OCEAN RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 W BALBOA BLVD
NEWPORT BEACH CA
92663-4527
US

IV. Provider business mailing address

3419 VIA LIDO SUITE 310
NEWPORT BEACH CA
92663-3908
US

V. Phone/Fax

Practice location:
  • Phone: 949-723-2388
  • Fax: 949-723-1288
Mailing address:
  • Phone: 949-723-2388
  • Fax: 949-723-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number300144AP
License Number StateCA

VIII. Authorized Official

Name: MADDY NAHIGYAN
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 949-524-1039