GULF COAST TREATMENT CENTER (NPI# 1700985462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700985462 |
| Entity Type | Organization |
| Organization Name | GULF COAST TREATMENT CENTER |
| Other Organization Name | GULF COAST YOUTH SERVICES |
| Practice Address |
1015 Mar Walt Drive Fort Walton Beach FL 32547 |
| Practice Telephone | 8508634160 |
| Practice Fax Number | 8508638576 |
| Mailing Telephone | 8508634160 |
| Mailing Fax Number | 8508638576 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2009-03-31 |
| Authorized Official Name | MR. JEFFREY M KAPLAN (CEO) |
| Authorized Official Telephone | 8508634160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 283Q00000X | Psychiatric Hospital | 4454 | FL | Hospitals |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 4454 | FL | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Gulf Coast Youth Services | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346396397 | Gulf Coast Treatment Center | Clinic/Center | 12271 Interchange Rd., Grand Bay, AL 36541 | 2007-01-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GULF COAST TREATMENT CENTER, INC. | 1015 Mar Walt Dr, Fort Walton Beach, FL 32547-6738 |
| Street Address |
1015 MAR WALT DRIVE |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831748706 | The National Center for Life and Liberty | Residential Treatment Facility, Emotionally Disturbed Children | 13702 Green Isle Ter, Clermont, FL 34711-8426 | 2019-09-04 |
| 1881177509 | Sailfuture | Residential Treatment Facility, Emotionally Disturbed Children | 2900 68th Ave S, St Petersburg, FL 33712-5525 | 2018-09-09 |
| 1760892111 | Loving Arms Outreach, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 608 Nw 15th Ave, Pompano Beach, FL 33069-2829 | 2014-05-06 |
| 1689016560 | Alternate Group Care, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 20250 Sw 50th Pl, Southwest Ranches, FL 33332-1021 | 2013-07-22 |
| 1528304714 | Linda Newsome | Residential Treatment Facility, Emotionally Disturbed Children | 1454 Bent Oaks Blvd, Deland, FL 32724-8062 | 2012-12-17 |
| 1528327335 | G4s Youth Services LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6302 Benjamin Rd Ste 400, Tampa, FL 33634-5116 | 2012-05-14 |
| 1003172073 | Esther's Group Home Corp. | Residential Treatment Facility, Emotionally Disturbed Children | 20115 Highland Lakes Blvd, N Miami Beach, FL 33179-2813 | 2012-04-04 |
| 1841584265 | D & R Rahabilitation Service Corp | Residential Treatment Facility, Emotionally Disturbed Children | 8567 Coral Way # 156, Miami, FL 33155-2335 | 2011-06-02 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1568795615 | Elite Behavioral Health Center | Residential Treatment Facility, Emotionally Disturbed Children | 611 Ne 13th St, Ft Lauderdale, FL 33304-1109 | 2009-09-08 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.