CORAL BAY RECOVERY LLC NPI 1003313131

NPI Information

  • NPI: 1003313131
  • Provider Name: CORAL BAY RECOVERY LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • CLIA Number: 10D2173227
  • Address: 3170 N FEDERAL HWY STE 206E
    LIGHTHOUSE POINT, FL
    ZIP 33064
  • Phone: (754) 444-1458

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NPI Details

CORAL BAY RECOVERY LLC is a rehabilitation and substance use disorder clinic center in Lighthouse Point, FL. CORAL BAY RECOVERY LLC NPI is 1003313131. The provider is registered as an organization entity type.

The provider's business location address is:

3170 N FEDERAL HWY STE 206E
LIGHTHOUSE POINT, FL
ZIP 33064-720
Phone: (754) 444-1458

The provider's authorized official is Mark Jacobson .
The authorized official title is Ceo and has the following contact phone number (954) 552-5100.

The CLIA number assigned to this NPI record is 10D2173227 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2018 and was last updated on 1/21/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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