Provider Demographics
NPI:1134592405
Name:OCEANS 6 REHAB, LLC
Entity type:Organization
Organization Name:OCEANS 6 REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CASE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:949-441-4456
Mailing Address - Street 1:33861 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2252
Mailing Address - Country:US
Mailing Address - Phone:949-441-4456
Mailing Address - Fax:480-383-6983
Practice Address - Street 1:33861 GRANADA DR
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2252
Practice Address - Country:US
Practice Address - Phone:949-441-4456
Practice Address - Fax:480-383-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility