Provider Demographics
NPI:1235561440
Name:SAN DIEGO COASTAL CAREGIVERS,LLC
Entity Type:Organization
Organization Name:SAN DIEGO COASTAL CAREGIVERS,LLC
Other - Org Name:HOMEHELPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN-BSN,PHN
Authorized Official - Prefix:MS
Authorized Official - First Name:LEILANIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:BINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-781-1060
Mailing Address - Street 1:8880 RIO SAN DIEGO DR STE 800
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1642
Mailing Address - Country:US
Mailing Address - Phone:619-781-1060
Mailing Address - Fax:
Practice Address - Street 1:8880 RIO SAN DIEGO DR STE 800
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1642
Practice Address - Country:US
Practice Address - Phone:619-781-1060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516526253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care