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10D1019143 CLIA NUMBER - COASTAL NURSECARE OF FLORIDA INC DBA ADDUS HOMECARE

Laboratory Demographics

CLIA Number: 10D1019143

Facility Name: COASTAL NURSECARE OF FLORIDA INC DBA ADDUS HOMECARE

Facility Address:
2160 CREIGHTON RD
PENSACOLA, FL
ZIP 32504
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Facility Phone Number: 850 475-9000

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1407841729

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 10D1019143
LAB Type Home Health Agency
Facility Name COASTAL NURSECARE OF FLORIDA INC DBA ADDUS HOMECARE
Street 2160 CREIGHTON RD
City PENSACOLA
State FL
ZIP 32504
Phone 850 475-9000
CertificateType 4
CertificateEffectiveDate 12/23/2023
CertificateExpirationDate 12/22/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024