Coastal Treatment Centers, Largo

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

COASTAL TREATMENT CENTERS, LARGO

Practice address

2057 Edgewater Dr
Clearwater, FL 33755-1028

Phone

(727) 205-7077

NPI assigned

Oct 31, 2022

Organization subpart

No

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

Authorized official

Name

Andre Genao

Title

Chief Compliance Officer

Phone

(352) 442-2643

Specialties & licenses 3

Addresses

Other names 1

• The Wave of Edgewater Doing business as

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1609583673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28059 US HIGHWAY 19 N STE 205",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 EDGEWATER DR",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337551028",
            "telephone_number": "727-205-7077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL TREATMENT CENTERS, LARGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "GENAO",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "352-442-2643"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wave of Edgewater",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coastal Hearing, Inc
• Coastal Home Care, Inc.
• Coastal Jaw Surgery of New Port Richey, P.a.
• Coastal Neuropsychology, LLC
• Coastal Treatment Center, Clearwater LLC
• Donald Bruce Cochran, OD OPTOMETRY DOCTOR
• John Barry Cochran
• John Michael Cochran, MD
• Jodianne C Coffee, PA-C
• Coffie Cares LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.