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General NPI Number Information
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NPI Number | 1174995211
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Entity Type | Organization
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Legal Business Name | COASTLINE HEALTHCARE SOLUTIONS, INC.
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 23046 AVENIDA DE LA CARLOTA SUITE 600
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1548
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Country | US
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Telephone | 855-426-2785
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Fax | 855-426-2785
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Provider Business Mailing Address
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Address Line | 23046 AVENIDA DE LA CARLOTA SUITE 600
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-1548
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Country | US
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Telephone | 855-426-2785
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Fax | 855-426-2785
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Authorized Official
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Title or Position | CO- FOUNDER
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Name | MR. VINCENT J JUHL
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Credential |
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Telephone | 855-426-2785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | C3581553
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License Number State | CA
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