Provider Demographics
NPI:1417393232
Name:COA HOME CARE, LLC
Entity Type:Organization
Organization Name:COA HOME CARE, LLC
Other - Org Name:COA IN HOME SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAROL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-253-4700
Mailing Address - Street 1:420 FENTRESS BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-1208
Mailing Address - Country:US
Mailing Address - Phone:386-283-4700
Mailing Address - Fax:386-253-6300
Practice Address - Street 1:420 FENTRESS BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1208
Practice Address - Country:US
Practice Address - Phone:386-253-4700
Practice Address - Fax:386-253-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994192251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251E00000XOtherHOME HEALTH PRIVATE DUTY CARE