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General NPI Number Information
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NPI Number | 1396032447
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Entity Type | Organization
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Legal Business Name | COASTAL HOME HEALTH & HOSPICE INC.
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 585 5TH ST
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City | BROOKINGS
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State | OR
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Zip | 97415-9702
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Country | US
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Telephone | 541-469-0405
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Fax | 541-469-6185
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Provider Business Mailing Address
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Address Line | PO BOX 6042
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City | BROOKINGS
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State | OR
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Zip | 97415-0137
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Country | US
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Telephone | 541-469-0405
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Fax | 541-469-6185
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Authorized Official
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Title or Position | CEO
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Name | JAMIE DAUGHERTY
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Credential | RN
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Telephone | 541-512-5041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 13-1502
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License Number State | OR
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