Basic Information
| Provider Information | |||||||||
| NPI: | 1346560729 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NARCONON SUNCOAST, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SUNCOAST REHABILITATION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1390 SUNSET POINT ROAD | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273044176 | ||||||||
| FaxNumber: | 9542085770 | ||||||||
| Practice Location | |||||||||
| Address1: | 1390 SUNSET POINT ROAD | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273044176 | ||||||||
| FaxNumber: | 9542085770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2010 | ||||||||
| LastUpdateDate: | 12/30/2015 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | STRICKLING | ||||||||
| AuthorizedOfficialFirstName: | SEAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | TREASURY SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 9545877771 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 0527AD198301 | FL | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.