Organization
COASTAL MENTAL HEALTH CENTER INC
Active
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
149 S RIDGEWOOD AVE STE 310, DAYTONA BEACH, FL 32114-4335
(800) 614-4124
Mailing address
665 W WARREN AVE, LONGWOOD, FL 32750-4004
(407) 347-6387
(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
—
000959609
—
FL
01
—
9391
EXEMPTION
FL
Enumeration date
03/02/2022
Last updated
07/04/2025
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