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COASTAL HOME CARE LLC NPI 1285777490


NPI Information

NPI: 1285777490
Provider Name: COASTAL HOME CARE, LLC
Classification: In Home Supportive Care - 253Z00000X
Entity Type: Organization
Address:
210 W PARK AVE
VALDOSTA, GA
ZIP 31602
Phone: (229) 671-9232
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COASTAL HOME CARE, LLC is an in home supportive care in Valdosta, GA. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. COASTAL HOME CARE, LLC NPI is 1285777490. The provider is registered as an organization entity type.

The provider's business location address is:

210 W PARK AVE
VALDOSTA, GA
ZIP 31602-507
Phone: (229) 671-9232

The provider's authorized official is Joseph Bonaccorsi .
The authorized official title is Chief Legal Officer and has the following contact phone number (312) 762-9999.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 2/8/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome Health025R0271GEORGIANo
2251E00000XHome Health016R0270GEORGIANo
3251E00000XHome Health063R0272GEORGIANo
4253Z00000XIn Home Supportive CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000609958PMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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