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General NPI Number Information
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NPI Number | 1477046076
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Entity Type | Organization
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Legal Business Name | SUNCOAST RECOVERY CENTER INC
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Dates
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Enumeration Date | 06/08/2018
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Last Update Date | 06/08/2018
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Provider Practice Location Address
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Address Line | 15225 US HIGHWAY 19
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City | HUDSON
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State | FL
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Zip | 34667-3673
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Country | US
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Telephone | 727-233-9856
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Fax |
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Provider Business Mailing Address
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Address Line | 13910 FIVAY RD STE 15
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City | HUDSON
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State | FL
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Zip | 34667-7130
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Country | US
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Telephone | 727-233-9856
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Fax | 727-484-6173
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ESTEBAN ALFONSO RUIZ
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Credential | MD
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Telephone | 727-484-6169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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