Provider Demographics
NPI:1235604596
Name:COASTAL CAREGIVERS HOME CARE INC.
Entity Type:Organization
Organization Name:COASTAL CAREGIVERS HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAREE
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:STRICKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-490-7226
Mailing Address - Street 1:2195 CABOOSE LN APT 302
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-3599
Mailing Address - Country:US
Mailing Address - Phone:850-490-7226
Mailing Address - Fax:
Practice Address - Street 1:3632 LAND O LAKES BLVD STE 106-20
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-4405
Practice Address - Country:US
Practice Address - Phone:727-212-5008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty