Provider Demographics
NPI:1174861512
Name:COASTAL HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:COASTAL HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEOUNG JU
Authorized Official - Middle Name:
Authorized Official - Last Name:RYOU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-670-2337
Mailing Address - Street 1:1220 BLALOCK RD
Mailing Address - Street 2:140
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6472
Mailing Address - Country:US
Mailing Address - Phone:214-290-4624
Mailing Address - Fax:
Practice Address - Street 1:4359 RITTIMAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-4362
Practice Address - Country:US
Practice Address - Phone:713-623-1391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health