MEDICARE: OCEAN HOUSE ADULT HOME

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	251E00000X	Home Health Agency

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	:	1376507483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN HOUSE ADULT HOME

Provider Business Mailing Address
First Line	:	1214 HEYSON RD
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-5511
Country	:	US
Telephone Number	:	347-804-8532
Fax Number	:

Provider Business Practice Location Address
First Line	:	1214 HEYSON RD
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-5511
Country	:	US
Telephone Number	:	347-804-8532
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	JOAN MARREN
Credential	:
Telephone Number	:	212-609-1521

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	08/22/2020

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Directions to “OCEAN HOUSE ADULT HOME ” Practice Location

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