Coastline Recovery LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

300630BP Issued in CA

Legal business name

COASTLINE RECOVERY LLC

Practice address

18377 Beach Blvd Ste 210
Huntington Beach, CA 92648-1349

Phone

(949) 205-1065

Fax

(714) 388-3844

NPI assigned

Oct 13, 2015

Organization subpart

No

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

Authorized official

Name

Jason Jacobs

Title

VP of Operations

Phone

(949) 345-5577

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Coastline Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Irvine, CA
  • NPI 1407216906
  NPPES parent name

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520899200000",
    "number": "1306217500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18377 BEACH BLVD STE 210",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481349",
            "telephone_number": "949-205-1065",
            "fax_number": "714-388-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18377 BEACH BLVD STE 210",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926481349",
            "telephone_number": "949-205-1065",
            "fax_number": "714-388-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTLINE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2018-03-13",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "949-345-5577"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "300630BP",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CA",
            "license": "300630BP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHCS CERTIFICATION",
            "identifier": "300630BP",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE JOINT COMMISSION",
            "identifier": "608177",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Primary Care
• Coastal Surgery Center, Inc.
• Coastline Anesthesia & Pain Management Group a Medical Corpora
• Coastline Dental Care
• Coastline Recovery for Women LLC
• Coastline Therapies
• Jeffrey Mark Coates, PT
• Heather Ann Cobb, BCBA
• Rachel Cochlin
• Karen Cocozza, L.AC.

• Substance Use Disorder Rehabilitation Clinic/Center in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.