| Coastal Therapeutic Effect, Llc | |
|
9390 Ford Ave Ste 3 Richmond Hill GA 31324-6418 | |
| (912) 596-0773 | |
| Not Available |
| Full Name | Coastal Therapeutic Effect, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9390 Ford Ave Ste 3, Richmond Hill, Georgia |
| Authorized Official Name and Position | Wendy Sue Cobernus-newell (OWNER) |
| Authorized Official Contact | 9125960773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Therapeutic Effect, Llc 9390 Ford Ave Ste 3 Richmond Hill GA 31324-6418 Ph: (912) 596-0773 | Coastal Therapeutic Effect, Llc 9390 Ford Ave Ste 3 Richmond Hill GA 31324-6418 Ph: (912) 596-0773 |
| NPI Number | 1982451407 |
|---|---|
| Provider Enumeration Date | 05/02/2024 |
| Last Update Date | 05/02/2024 |
| Certification Date | 05/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982451407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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