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General NPI Number Information
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NPI Number | 1013392240
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Entity Type | Organization
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Legal Business Name | COASTAL CARE SERVICES, INC
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 1200 NW 78TH AVE STE 100
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City | DORAL
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State | FL
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Zip | 33126-1816
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Country | US
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Telephone | 855-481-0505
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Fax | 855-481-0606
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Provider Business Mailing Address
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Address Line | 1200 NW 78TH AVE STE 100
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City | DORAL
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State | FL
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Zip | 33126-1816
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Country | US
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Telephone | 855-481-0505
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Fax |
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Authorized Official
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Title or Position | SENIOR VP
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Name | MR. YSEL GARCIA
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Credential |
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Telephone | 855-481-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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