Coastal Treatment Center, Nokomis LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

COASTAL TREATMENT CENTER, NOKOMIS LLC

Doing business as

The Wave of Sarasota

Practice address

119 Tamiami TRL N
Nokomis, FL 34275-2120

Phone

(727) 309-7993

NPI assigned

Aug 8, 2018

Last updated

Aug 8, 2018By 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

Christopher Wright Fox

Title

President

Phone

(310) 547-7501

Specialties & licenses 1

Addresses

Other names 1

• The Wave of Sarasota Doing business as

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533686400000",
    "number": "1982183273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 TAMIAMI TRL N",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 TAMIAMI TRL N",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752120",
            "telephone_number": "727-309-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL TREATMENT CENTER, NOKOMIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "WRIGHT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-547-7501"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wave of Sarasota",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Albert Eugene Charron, MD
• Chase Surgical Solutions, LLC
• Sophia Gail Ciaravino, MD
• Coastal Care Nursing Associates, Inc
• Coastal Care Tampa Bay
• Comfortable Care Dental Health Professionals, P.a. (Nokomis Dental Care)
• Comfortable Medical Supplies, 'LLC'
• Mara Megan Crowe, RBT
• Lynn Daigler, ITDS CERTIFICATE
• Danielle Lynn Decubellis, ARNP

• Substance Abuse Rehabilitation Facility in Nokomis, FL
• Providers in Nokomis, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.