NPIMap

Organization Active NPI

Coastal Addiction Recovery LLC

  • Adult Mental Health Clinic/Center
  • North Charleston, SC
National Provider Identifier
1083184576
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
COASTAL ADDICTION RECOVERY LLC
Practice address
2179 Ashley Phosphate Rd Ste B
North Charleston, SC 29406-4180
Phone
(843) 718-3168
NPI assigned
Nov 28, 2018
Last updated
Nov 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Authorized official

Name
Jodie Moore
Title
Director of Operations
Phone
(843) 718-3168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary

Addresses

Primary practice location

2179 Ashley Phosphate Rd Ste B
North Charleston, SC 29406-4180

Mailing address

2179 Ashley Phosphate Rd Ste B
North Charleston, SC 29406-4180

National Provider Directory

National Provider Directory
Tax ID family
Coastal Addiction Recovery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543363200000",
    "number": "1083184576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2179 ASHLEY PHOSPHATE RD STE B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2179 ASHLEY PHOSPHATE RD STE B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294064180",
            "telephone_number": "843-718-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ADDICTION RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JODIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "843-718-3168"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.