National Provider Identifier Database

COASTAL RECOVERY WELLNESS LLC
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

COASTAL RECOVERY & WELLNESS, LLC
1113 44TH AVENUE NORTH
SUITE 100
MYRTLE BEACH, SC29577
Phone: 843-449-6261
Fax: 843-449-8171
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Addiction (Substance Use Disorder) 101YA0400X
Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for COASTAL RECOVERY & WELLNESS, LLC

NPI Number 1386869337
Legal business name
LBN
COASTAL RECOVERY & WELLNESS, LLC
Authorized official SPENCER JOSEY - (CEO)
Entity Organization
Organization subpart No
Enumeration date 04/16/2007
Last updated 10/27/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • SC License #: DHEC OTP-092

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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