COASTAL DETOX INC NPI 1598130098

NPI Information

  • NPI: 1598130098
  • Provider Name: COASTAL DETOX, INC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • CLIA Number: 10D2111360
  • Address: 1131 SE INDIAN ST
    STUART, FL
    ZIP 34997
  • Phone: (772) 612-0130

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NPI Details

COASTAL DETOX, INC is a substance abuse rehabilitation facility in Stuart, FL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. COASTAL DETOX, INC NPI is 1598130098. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1131 SE INDIAN ST
STUART, FL
ZIP 34997-688
Phone: (772) 612-0130

The provider's authorized official is Christina Tucker .
The authorized official title is Chief Executive Officer and has the following contact phone number (772) 219-1355.

The CLIA number assigned to this NPI record is 10D2111360 - other - inpatient detox with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/9/2015 and was last updated on 10/1/2024.

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
1111NX0100XChiropractorOccupational HealthNo
22084P0800XPsychiatry & NeurologyPsychiatryNo
3225700000XMassage TherapistNo
4284300000XSpecial HospitalNo
5324500000XSubstance Abuse Rehabilitation FacilityYes
6363A00000XPhysician AssistantNo
7363AM0700XPhysician AssistantMedicalNo
8363LF0000XNurse PractitionerFamilyNo

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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