COASTAL TREATMENT CENTER, CLEARWATER LLC (NPI# 1992284285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992284285 |
| Entity Type | Organization |
| Organization Name | COASTAL TREATMENT CENTER, CLEARWATER LLC |
| Other Organization Name | THE WAVE OF CLEARWATER |
| Practice Address |
2120 Range Rd Clearwater FL 33765 |
| Mailing Address |
2120 Range Rd Clearwater FL 33765-2125 |
| Practice Telephone | 7272057077 |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2019-06-13 |
| Authorized Official Name | CHRISTOPHER WRIGHT FOX (PRESIDENT) |
| Authorized Official Telephone | 3105477501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| The Wave of Clearwater | Doing Business As Name - Organization |
| Street Address |
2120 RANGE RD |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538484910 | Charles Clement Robinson | Counselor | 2120 Range Rd, Clearwater, FL 33765-2125 | 2010-03-29 |
| 1588130363 | The Wave International, LLC | Clinic/Center | 2120 Range Rd, Clearwater, FL 33765-2125 | 2018-10-18 |
| 1306209853 | Empower, LLC | Psychiatry & Neurology | 2120 Range Rd, Clearwater, FL 33765-2125 | 2016-04-01 |
| 1861877573 | Empower, LLC | Substance Abuse Rehabilitation Facility | 2120 Range Rd, Clearwater, FL 33765-2125 | 2015-07-23 |
| 1003223421 | Empower, LLC | Community/Behavioral Health | 2120 Range Rd, Clearwater, FL 33765-2125 | 2014-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023654449 | Seawa Enterprise LLC | Durable Medical Equipment & Medical Supplies | 1802 North Belcher Road, Suite 100, Clearwater, FL 33765 | 2019-11-20 |
| 1962996140 | Jeremy Scott Martin | Clinic/Center | 2481 N.e. Coachman Rd, Clearwater, FL 33765 | 2018-06-20 |
| 1891172078 | Comprehensive Surgery Center LLC | Clinic/Center | 407 Aurora Ave, Clearwater, FL 33765 | 2015-04-27 |
| 1184050411 | Anthony Richard Cheslock | Dentist | 1831 Belcher Road North, 1-b, Clearwater, FL 33765 | 2013-09-18 |
| 1548609522 | Andrew S Cormier | Optometrist | 2288 Drew Street, Suite B, Clearwater, FL 33765 | 2013-06-23 |
| 1124372412 | Kelly Ann Potts | Acupuncturist | 112 Evelyn Avenue, Clearwater, FL 33765 | 2012-11-08 |
| 1235402876 | Jerry N Karasick | Chiropractor | 901 N. Hercules Ave, Ste C, Clearwater, FL 33765 | 2012-02-13 |
| 1538329362 | Aei Diagnostic Imaging LLC | Clinic/Center | 1831 N Belcher Road, D Building, Clearwater, FLORIDA 33765 | 2008-06-16 |
| 1700053311 | Loredana Repetto | Social Worker | 2329 Sunset Point Road, Suite 203, Clearwater, FL 33765 | 2008-05-13 |
| 1679741920 | Kussel & Associates Inc. | Podiatrist | 2378 Sunset Point Rd, Clearwater, FL 33765 | 2008-02-20 |
| Find all providers in zip 33765 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811317225 | Veteran's Transitional Housing, Inc. | Community Based Residential Treatment Facility, Mental Illness | 403 Princess St, Clearwater, FL 33755-1730 | 2014-04-24 |
| 1063606028 | Orchids Home | Community Based Residential Treatment Facility, Mental Illness | 2690 Meadow Oak Drive, Clearwater, FL 33761 | 2007-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427688852 | Tropical Gardens LLC | Community Based Residential Treatment Facility, Mental Illness | 150 Ne 212th St, Miami Gardens, FL 33179-1017 | 2020-01-24 |
| 1417505850 | Herve Franck | Community Based Residential Treatment Facility, Mental Illness | 13901 Folkestone Cir, Wellington, FL 33414-7825 | 2019-08-28 |
| 1568014868 | Hestia House of Florida, Inc. | Community Based Residential Treatment Facility, Mental Illness | 816 N Grandview Ave # 2, Daytona Beach, FL 32118-3721 | 2019-07-16 |
| 1336628155 | Lavoryia Timmons | Community Based Residential Treatment Facility, Mental Illness | 24940 Hyde Park Blvd, Land O Lakes, FL 34639-6306 | 2018-08-13 |
| 1003324534 | Donyell Jones | Community Based Residential Treatment Facility, Mental Illness | 6239 Edgewater Dr Ste V2, Orlando, FL 32810-4764 | 2018-01-18 |
| 1437672748 | Reasons for Change, LLC | Community Based Residential Treatment Facility, Mental Illness | 143 Silver Beach Road, Lake Park, FL 33403 | 2017-07-18 |
| 1316477029 | Cerrato Associates Incorporation | Community Based Residential Treatment Facility, Mental Illness | 755 Shady Oaks Dr Apt 310, Palm Coast, FL 32164-2578 | 2017-06-14 |
| 1356877047 | Samaritan Counseling Center | Community Based Residential Treatment Facility, Mental Illness | 101 Se 3rd Avenue, Fort Lauderdale, FL 33301 | 2017-05-02 |
| 1780119917 | Open Arm Housing and Care | Community Based Residential Treatment Facility, Mental Illness | 4031 Nw 91st Ters, Sunrise, FL 33351 | 2017-04-25 |
| 1124476064 | Parent Support, LLC | Community Based Residential Treatment Facility, Mental Illness | 146 Sunset View Dr., Davenport, FL 33896 | 2016-06-01 |
| Find all providers with the same taxonomy | ||||
| City | CLEARWATER |
| Zip Code | 33765 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.