Healthcare Provider Details

I. General information

NPI: 1356217376
Provider Name (Legal Business Name): COASTAL CCARE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2158 BLUESTONE CIR
CHULA VISTA CA
91913-4001
US

IV. Provider business mailing address

830 KUHN DR UNIT 211423
CHULA VISTA CA
91921-8058
US

V. Phone/Fax

Practice location:
  • Phone: 619-392-4485
  • Fax:
Mailing address:
  • Phone: 619-392-4485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KEYSHIRA MONEE KEELING
Title or Position: OWNER
Credential:
Phone: 757-943-6962