NPIMap

Organization Active NPI

Recovery Coast

  • Substance Abuse Rehabilitation Facility
  • Jacksonville, FL
National Provider Identifier
1780134874
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RECOVERY COAST
Practice address
340 16TH Ave N
Jacksonville, FL 32250-4819
Phone
(904) 429-4422
Fax
(904) 429-3472
NPI assigned
Oct 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Authorized official

Name
Tim Johnson
Title
Ceo
Phone
(904) 429-4422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

340 16TH Ave N
Jacksonville, FL 32250-4819

Mailing address

340 16TH Ave N
Jacksonville, FL 32250-4819
Phone (904) 429-4422

National Provider Directory

National Provider Directory
Tax ID family
Recovery Coast3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1780134874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 16TH AVE N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322504819",
            "telephone_number": "904-429-4422",
            "fax_number": "904-429-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 16TH AVE N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322504819",
            "telephone_number": "904-429-4422",
            "fax_number": "904-429-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-429-4422"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 12, 2016; 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.