NPIMap

Organization Active NPI

Coastal Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Jacksonville, FL
National Provider Identifier
1306593181
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COASTAL MENTAL HEALTH CENTER INC
Practice address
8382 Baymeadows Rd Ste 7
Jacksonville, FL 32256-7436
Phone
(407) 347-6387
Fax
(888) 217-4124
NPI assigned
Mar 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Tamar Richardson
Title
Director
Phone
(407) 347-6387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

8382 Baymeadows Rd Ste 7
Jacksonville, FL 32256-7436

Mailing address

665 W Warren Ave
Longwood, FL 32750-4004
Phone (407) 347-6387

Other identifiers 2

IdentifierTypeStateIssuer
000959612MedicaidFL
15474OtherFLEXEMPTION

National Provider Directory

National Provider Directory
Tax ID family
Coastal Mental Health Center Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

8382 Baymeadows Rd
Ste 7
Jacksonville, FL 32256
Phone (407) 347-6387

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1306593181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504004",
            "telephone_number": "407-347-6387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8382 BAYMEADOWS RD STE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567436",
            "telephone_number": "407-347-6387",
            "fax_number": "888-217-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MENTAL HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TAMAR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-347-6387"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000959612",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXEMPTION",
            "identifier": "15474",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.