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General NPI Number Information
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NPI Number | 1609044924
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST HOME HEALTH INC
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 253 GRANADA DR SUITE D
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7340
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Country | US
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Telephone | 805-543-2244
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Fax | 805-543-2224
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Provider Business Mailing Address
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Address Line | 253 GRANADA DR SUITE D
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7340
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Country | US
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Telephone | 805-543-2244
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Fax | 805-543-2224
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN PRITT
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Credential |
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Telephone | 805-543-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 550000764
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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