Provider Demographics
NPI:1598996746
Name:COASTAL CARE INC
Entity Type:Organization
Organization Name:COASTAL CARE INC
Other - Org Name:ACCESSIBLE HOME HEALTH CARE OF THE L. A. COAST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALLANTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-543-3211
Mailing Address - Street 1:21707 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-7009
Mailing Address - Country:US
Mailing Address - Phone:310-543-3211
Mailing Address - Fax:310-543-3223
Practice Address - Street 1:21707 HAWTHORNE BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-7009
Practice Address - Country:US
Practice Address - Phone:310-543-3211
Practice Address - Fax:310-543-3223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health