Uhs of Savannah, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

025618 Issued in GA

Legal business name

UHS OF SAVANNAH, LLC

Doing business as

Coastal Harbor Treatment Center

Practice address

1150 Cornell Ave
Savannah, GA 31406-2702

Phone

(912) 354-3911

Fax

(912) 355-1336

NPI assigned

Oct 19, 2016

Last updated

Oct 19, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

UHSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sally Perry

Title

Ceo

Phone

(912) 354-3911

Specialties & licenses 1

Addresses

Other names 1

• Coastal Harbor Treatment Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073064564. Details of each certification follow.

• CCN 11L001 Psychiatric residential treatment facility · Active · Name & address match · Details

Psychiatric residential treatment facility certification: CCN 11L001

Legal name

COASTAL HARBOR TREATMENT CENTER (PRTF)

Certification status

Active

Provider type (POS)

Psychiatric residential treatment facility

Participating since

Jun 28, 2008

Last certification

Aug 15, 2018

Beds

125

Ownership / control type

For profit – partnership

Facility address

1150 Cornell Avenue
Savannah, GA 31406

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1073064564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 CORNELL AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062702",
            "telephone_number": "912-354-3911",
            "fax_number": "912-355-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 CORNELL AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062702",
            "telephone_number": "912-354-3911",
            "fax_number": "912-355-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UHS OF SAVANNAH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UHS",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-354-3911"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "GA",
            "license": "025618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Harbor Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Dimarco Uccardi
• Andre Becker Uflacker, M.D.
• Uhs of Savannah LLC (Coastal Behavioral Health)
• Uhs of Savannah LLC (Coastal Harbor Health System)
• Uhs of Savannah, LLC (Coastal Behavioral Health IOP Program)
• Uhs of Savannah, LLC (Coastal Harbor Treatment Center)
• Unconditional Helping Hands, LLC.
• Jesse Allan Underwood, PHARMACIST
• Stephany Underwood, LPC
• Uneeka Perspective LLC

• Psychiatric Residential Treatment Facility in Savannah, GA
• Providers in Savannah, GA by specialty
• Psychiatric Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.