Provider Demographics
NPI:1902453038
Name:OCEAN BREEZE HOME HEALTH INC
Entity Type:Organization
Organization Name:OCEAN BREEZE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FLOR
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-212-7978
Mailing Address - Street 1:PO BOX 2012
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:CA
Mailing Address - Zip Code:93926-2012
Mailing Address - Country:US
Mailing Address - Phone:800-207-0611
Mailing Address - Fax:800-214-3114
Practice Address - Street 1:132 ALTA STREET
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:CA
Practice Address - Zip Code:93926
Practice Address - Country:US
Practice Address - Phone:800-207-0611
Practice Address - Fax:800-214-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty