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
8382 BAYMEADOWS RD STE 7, JACKSONVILLE, FL 32256-7436
(407) 347-6387
(888) 217-4124
Mailing address
665 W WARREN AVE, LONGWOOD, FL 32750-4004
(407) 347-6387
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000959612
—
FL
01
—
15474
EXEMPTION
FL
Enumeration date
03/02/2022
Last updated
03/02/2022
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