Coastal Recovery Center

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

230562 Issued in CA

Legal business name

COASTAL RECOVERY CENTER

Practice address

117 E Harry Bridges Blvd
Wilmington, CA 90744-5825

Phone

(310) 549-8383

Fax

(310) 549-9304

NPI assigned

Dec 12, 2007

Last updated

Dec 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Andrea AdamsNPI 1417174558

Title

Director

Phone

(310) 549-8383

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea C Adams, CAS-RAS

  • Addiction (Substance Use Disorder) Counselor
  • Wilmington, CA
  • NPI 1417174558
  Authorized official Same address or phone

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1710160833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19109 GALWAY AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461915",
            "telephone_number": "310-329-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E HARRY BRIDGES BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907445825",
            "telephone_number": "310-549-8383",
            "fax_number": "310-549-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-549-8383",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "230562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.