| Coastal Mental Health Center Inc | |
|
801 Beville Rd Ste 202a South Daytona FL 32119-1862 | |
| (407) 347-6387 | |
| (888) 217-4124 |
| Full Name | Coastal Mental Health Center Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 801 Beville Rd Ste 202a, South Daytona, Florida |
| Authorized Official Name and Position | Tamar Richardson (DIRECTOR) |
| Authorized Official Contact | 4073476387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Mental Health Center Inc 665 W Warren Ave Longwood FL 32750-4004 Ph: (407) 347-6387 | Coastal Mental Health Center Inc 801 Beville Rd Ste 202a South Daytona FL 32119-1862 Ph: (407) 347-6387 |
| NPI Number | 1194472977 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 03/02/2022 |
| Certification Date | 03/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194472977 | NPI | - | NPPES |
| 9391 | Other | FL | EXEMPTION |
| 000959609 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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