Healthcare Provider Details

I. General information

NPI: 1306764980
Provider Name (Legal Business Name): COAST CARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10570 S US HIGHWAY 1 STE 57
PORT SAINT LUCIE FL
34952-5606
US

IV. Provider business mailing address

10570 S US HIGHWAY 1 STE 57
PORT SAINT LUCIE FL
34952-5606
US

V. Phone/Fax

Practice location:
  • Phone: 561-685-4597
  • Fax:
Mailing address:
  • Phone: 561-685-4597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: LIENY ENRIQUEZ CHINEA
Title or Position: CEO
Credential:
Phone: 561-685-4597