Organization
GULF COAST RECOVERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW B SCHWARZ (CEO)
(727) 367-9662
Entity
Organization
Contact information
Practice address
145 108TH AVENUE, TREASURE ISLAND, FL 33706
(727) 367-9662
(727) 367-9661
Mailing address
145 108TH AVENUE, TREASURE ISLAND, FL 33706
(727) 367-9662
(727) 367-9661
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
548542
VALUE OPTION
—
01
—
S6D
BCBS OF FLORIDA
FL
Enumeration date
04/17/2007
Last updated
08/22/2020
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