Organization
COASTAL MENTAL HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMAR RICHARDSON (DIRECTOR)
(407) 347-6387
Entity
Organization
Contact information
Practice address
2900 17TH ST STE 3, SAINT CLOUD, FL 34769-6098
(800) 614-4124
(888) 217-4124
Mailing address
665 W WARREN AVE, LONGWOOD, FL 32750-4004
(800) 614-4124
(888) 217-4124
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000959605
—
FL
Enumeration date
03/09/2022
Last updated
01/11/2024
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