Provider Demographics
NPI:1073989513
Name:RESTORATIVE HEALTH SERVICES, LLC DBA COASTAL HOME HEALTH CARE
Entity Type:Organization
Organization Name:RESTORATIVE HEALTH SERVICES, LLC DBA COASTAL HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-758-5200
Mailing Address - Street 1:5541 BEAR LN
Mailing Address - Street 2:STE 218
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-4129
Mailing Address - Country:US
Mailing Address - Phone:361-758-5200
Mailing Address - Fax:361-758-5206
Practice Address - Street 1:5541 BEAR LN
Practice Address - Street 2:STE 218
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-4129
Practice Address - Country:US
Practice Address - Phone:361-758-5200
Practice Address - Fax:361-758-5206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016554251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based