NPI:
1306343694
Provider Name:
COASTAL FAMILY HEALTH CENTER, INC
Other Name: COASTAL FAMILY HEALTH CENTER, INC - KREOLE SCHOOL CLINIC
Classification:
Clinic/Center - 261QF0400X
Entity Type:
Organization
Specialization: Federally Qualified Health Center (FQHC)
CLIA Number: 25D2159164
Address:
6312 MARTIN LUTHER KING BLVD
MOSS POINT, MS
ZIP 39563
Phone:
(228) 475-3719
Get Directions
COASTAL FAMILY HEALTH CENTER, INC is a federally qualified health center (fqhc) clinic center in Moss Point, MS. COASTAL FAMILY HEALTH CENTER, INC NPI is 1306343694. The provider is registered as an organization entity type.
The provider Other Name Is Coastal Family Health Center, Inc - Kreole School Clinic.
The provider's business location address is:
6312 MARTIN LUTHER KING BLVD
MOSS POINT, MS
ZIP 39563-126
Phone: (228) 475-3719
The provider's authorized official is Angelique Greer .
The authorized official title is Ceo and has the following contact phone number (228) 374-2494.
The CLIA number assigned to this NPI record is 25D2159164 - school/student health service with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 4/12/2018 and was last updated on 4/12/2018.