Organization
CORAL BAY RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JACOBSON LMFT, MCAP (CEO)
(954) 552-5100
Entity
Organization
Contact information
Practice address
3170 N FEDERAL HWY STE 206E, LIGHTHOUSE POINT, FL 33064-6720
(754) 444-1458
Mailing address
3170 N FEDERAL HWY STE 204A, LIGHTHOUSE POINT, FL 33064-6736
(954) 552-5100
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2018
Last updated
01/21/2025
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