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General NPI Number Information
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NPI Number | 1134591480
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Entity Type | Organization
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Legal Business Name | COAST WISE SOLUTION
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 2728 54TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90043
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Country | US
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Telephone | 888-560-5595
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Fax | 888-706-3040
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Provider Business Mailing Address
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Address Line | 2728 54TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90043
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Country | US
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Telephone | 888-560-5595
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Fax | 888-760-3040
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Authorized Official
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Title or Position | CO OWNER / CONSULTING NURSE
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Name | ROSITA ASHBY
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Credential |
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Telephone | 18885605595
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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 | 2015173561
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License Number State | CA
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