Healthcare Provider Details

I. General information

NPI: 1750908000
Provider Name (Legal Business Name): OCEANS L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2020
Last Update Date: 07/02/2020
Certification Date: 07/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9799 ALEUTIAN ST
LAS VEGAS NV
89178-3844
US

IV. Provider business mailing address

1350 EAST FLAMINGO ROAD SUITE 13B UNIT 610
LAS VEGAS NV
89119
US

V. Phone/Fax

Practice location:
  • Phone: 702-741-1604
  • Fax:
Mailing address:
  • Phone: 775-301-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM ADAM BROBST
Title or Position: CO-OWNER
Credential: MFT-I
Phone: 775-301-2425