Organization
LIBRE BEHAVIORAL HEALTHCARE LLC
Active
Other names
Coastal Behavioral
Organization subpart
No
Provider details
NPI number
Authorized official
MARK NAGRANI MD (OWNER)
(407) 522-9919
Entity
Organization
Contact information
Practice address
3930 S NOVA RD STE 106, PORT ORANGE, FL 32127-9293
(386) 492-6894
(407) 522-9343
Mailing address
612 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 492-6894
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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