Healthcare Provider Details

I. General information

NPI: 1598828436
Provider Name (Legal Business Name): COASTAL KIDS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 MERRILL ST SUITE 2015
SALINAS CA
93901-4495
US

IV. Provider business mailing address

1172 S MAIN ST # 125
SALINAS CA
93901-2204
US

V. Phone/Fax

Practice location:
  • Phone: 800-214-5439
  • Fax: 831-796-0334
Mailing address:
  • Phone: 800-214-5439
  • Fax: 831-796-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. MARGY MAYFIELD
Title or Position: DIRECTOR OF CLINICAL SERVICES
Credential: RN
Phone: 800-214-5439