Provider Demographics
NPI:1073064564
Name:UHS OF SAVANNAH, LLC
Entity Type:Organization
Organization Name:UHS OF SAVANNAH, LLC
Other - Org Name:COASTAL HARBOR TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-354-3911
Mailing Address - Street 1:1150 CORNELL AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2702
Mailing Address - Country:US
Mailing Address - Phone:912-354-3911
Mailing Address - Fax:912-355-1336
Practice Address - Street 1:1150 CORNELL AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2702
Practice Address - Country:US
Practice Address - Phone:912-354-3911
Practice Address - Fax:912-355-1336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UHS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025618323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility