Healthcare Provider Details
I. General information
NPI: 1841071255
Provider Name (Legal Business Name): COASTAL TURNING POINT INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
129 S RIVER ST
SANTA CRUZ CA
95060-4524
US
IV. Provider business mailing address
147 S RIVER ST STE 234A
SANTA CRUZ CA
95060-4556
US
V. Phone/Fax
- Phone: 831-234-2010
- Fax: 831-226-2123
- Phone: 831-818-5963
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3245S0500X |
| Taxonomy | Children's Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CASSIA
LEA
BLOOM
Title or Position: OWNER EXECUTIVE DIRECTOR
Credential: MFT, LPC
Phone: 831-234-2010