Organization
OCEANS BEHAVIORAL HOSPITAL OF DERIDDER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART ARCHER (CEO)
(972) 464-0022
Entity
Organization
Contact information
Practice address
1420 BLANKENSHIP DRIVE, DERIDDER, LA 70634
(337) 460-9472
(337) 460-9473
Mailing address
3905 HEDGCOXE RD UNIT 250249, PLANO, TX 75025-0840
(972) 464-0022
(972) 464-0021
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
580
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523879
—
LA
05
—
191013501
—
TX
01
—
DHHLICENSE 580
DHH LICENSE
—
Enumeration date
11/06/2006
Last updated
10/02/2023
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