Healthcare Provider Details

I. General information

NPI: 1851341432
Provider Name (Legal Business Name): OCEANS BEHAVIORAL HOSPITAL OF LAFAYETTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/11/2021
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 ALBERTSON PARKWAY
BROUSSARD LA
70518
US

IV. Provider business mailing address

3905 HEDGCOXE RD UNIT 250249
PLANO TX
75025-0840
US

V. Phone/Fax

Practice location:
  • Phone: 337-237-6444
  • Fax: 337-237-6445
Mailing address:
  • Phone: 972-464-0022
  • Fax: 337-721-1976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number548
License Number StateLA

VIII. Authorized Official

Name: LAURA F. TARANTINO
Title or Position: EVP/CORP. COUNSEL
Credential:
Phone: 972-464-0022