Provider Demographics
NPI:1083001317
Name:OCEAN HEALTHCARE PCP-ATLANTIC LLC
Entity Type:Organization
Organization Name:OCEAN HEALTHCARE PCP-ATLANTIC LLC
Other - Org Name:TAYLOR CARE ADULT BEHAVIORAL LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AVRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FEIGENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-364-7100
Mailing Address - Street 1:319 CHRIS GAUPP DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4462
Mailing Address - Country:US
Mailing Address - Phone:609-404-4220
Mailing Address - Fax:
Practice Address - Street 1:319 CHRIS GAUPP DR
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4462
Practice Address - Country:US
Practice Address - Phone:609-404-4220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)