Provider Demographics
NPI:1023738606
Name:OCEANS BEHAVIORAL HOSPITAL OF TUPELO, LLC
Entity type:Organization
Organization Name:OCEANS BEHAVIORAL HOSPITAL OF TUPELO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAARMACEUTICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-303-6240
Mailing Address - Street 1:4579 S EASON BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6539
Mailing Address - Country:US
Mailing Address - Phone:662-268-4418
Mailing Address - Fax:888-255-5803
Practice Address - Street 1:4579 S EASON BLVD STE B
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6539
Practice Address - Country:US
Practice Address - Phone:662-268-4418
Practice Address - Fax:888-255-5803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty