Organization
OCEAN ROAD LLC
Active
Organization
OCEAN ROAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH ANN FERGUSON L.C.S.W. (EXECUTIVE DIRECTOR)
(386) 527-2160
Entity
Organization
Contact information
Practice address
3520 W INTERNATIONAL SPEEDWAY BLVD, DAYTONA BEACH, FL 32124-1026
(386) 527-2160
Mailing address
PO BOX 2633, BUNNELL, FL 32110-2633
(386) 527-2160
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW10893
FL
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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