National Provider Identifier Database

COASTAL ADDICTION RECOVERY LLC
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

COASTAL ADDICTION RECOVERY LLC
2179 ASHLEY PHOSPHATE RD STE B
NORTH CHARLESTON, SC29406-4180
Phone: 843-718-3168
Fax:
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X
Addiction (Substance Use Disorder) 101YA0400X
Addiction Psychiatry 2084P0802X
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X
Mental Health 101YM0800X
Psychiatry 2084P0800X

* Indicates primary specialty

NPI Profile & details for COASTAL ADDICTION RECOVERY LLC

NPI Number 1942701792
Legal business name
LBN
COASTAL ADDICTION RECOVERY LLC
Authorized official JODI MOORE - (EXECUTIVE ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 02/27/2018
Last updated 02/27/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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