Organization
COASTAL BEHAVIORAL HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS GEORGIA ANN OLEARY RN (RN)
94133128530
Entity
Organization
Contact information
Practice address
6039 BENEVENTO DR, SARASOTA, FL 34238-2883
(941) 552-6272
Mailing address
6039 BENEVENTO DR, SARASOTA, FL 34238-2883
(941) 552-6272
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
RN9292201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
COASTAL BEHAVIORAL HEALTH CARE OUT PATIENT
FL
05
—
163W00000X
—
FL
Enumeration date
10/09/2015
Last updated
10/09/2015
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