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General NPI Number Information
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NPI Number | 1295167559
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Entity Type | Organization
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Legal Business Name | GULF COAST ADDICTION TREATMENT
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 3391 SCENIC HIGHWAY 98
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City | DESTIN
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State | FL
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Zip | 32541-4748
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Country | US
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Telephone | 954-678-0078
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Fax | 954-370-6447
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Provider Business Mailing Address
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Address Line | 3391 SCENIC HIGHWAY 98
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City | DESTIN
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State | FL
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Zip | 32541-4748
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Country | US
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Telephone | 954-678-0078
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Fax | 954-370-6447
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MARK SEIFERT
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Credential |
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Telephone | 954-678-0078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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