Healthcare Provider Details

I. General information

NPI: 1982997664
Provider Name (Legal Business Name): CENTRAL COAST SENIOR SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2011
Last Update Date: 09/18/2021
Certification Date: 09/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 LOWER RAGSDALE DR SUITE E
MONTEREY CA
93940-5775
US

IV. Provider business mailing address

22 LOWER RAGSDALE DR SUITE E
MONTEREY CA
93940-5775
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-3363
  • Fax:
Mailing address:
  • Phone: 831-649-3363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN O'BRIEN
Title or Position: CEO/PRESIDENT
Credential:
Phone: 831-649-3363