Provider Demographics
NPI:1225188592
Name:COASTAL BEND ADULT DAY CARE, INC.
Entity Type:Organization
Organization Name:COASTAL BEND ADULT DAY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:361-229-3705
Mailing Address - Street 1:PO BOX 1147
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:TX
Mailing Address - Zip Code:78358-1147
Mailing Address - Country:US
Mailing Address - Phone:361-729-5433
Mailing Address - Fax:361-729-6612
Practice Address - Street 1:102 BROADWAY
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:TX
Practice Address - Zip Code:78358
Practice Address - Country:US
Practice Address - Phone:361-729-5433
Practice Address - Fax:361-729-6612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117082261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care