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Organization

COASTAL ADDICTION RECOVERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JODIE MOORE (DIRECTOR OF OPERATIONS)
(843) 718-3168
Entity
Organization

Contact information

Practice address
2179 ASHLEY PHOSPHATE RD STE B, NORTH CHARLESTON, SC 29406-4180
(843) 718-3168
Mailing address
2179 ASHLEY PHOSPHATE RD STE B, NORTH CHARLESTON, SC 29406-4180

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Enumeration date
11/28/2018
Last updated
11/28/2018
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