Provider Demographics
NPI:1689004939
Name:OCEANS BEHAVIORAL HOSPITAL OF LUFKIN, LLC
Entity type:Organization
Organization Name:OCEANS BEHAVIORAL HOSPITAL OF LUFKIN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-464-0022
Mailing Address - Street 1:3905 HEDGCOXE RD UNIT 250249
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-0840
Mailing Address - Country:US
Mailing Address - Phone:972-464-0022
Mailing Address - Fax:972-464-0021
Practice Address - Street 1:302 GOBBLERS KNOB RD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-5419
Practice Address - Country:US
Practice Address - Phone:936-632-2276
Practice Address - Fax:936-632-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-24
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100233OtherHOSPITAL LICENSE
454123OtherMEDICARE CERTIFICATE NUMBER