Provider Demographics
NPI:1982226221
Name:COATC LLC
Entity Type:Organization
Organization Name:COATC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-904-8711
Mailing Address - Street 1:1807 E LAWSON RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-5012
Mailing Address - Country:US
Mailing Address - Phone:501-904-8711
Mailing Address - Fax:844-270-4888
Practice Address - Street 1:1807 E LAWSON RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-5012
Practice Address - Country:US
Practice Address - Phone:501-904-8711
Practice Address - Fax:844-270-4888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COATC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-09
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty