Provider Demographics
NPI:1679825525
Name:GOLD COAST CARE
Entity Type:Organization
Organization Name:GOLD COAST CARE
Other - Org Name:CORPORATE WELLNESS CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLOWICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:516-457-8284
Mailing Address - Street 1:3 TAPPENTOWN LN
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-3320
Mailing Address - Country:US
Mailing Address - Phone:516-457-8284
Mailing Address - Fax:
Practice Address - Street 1:3 TAPPENTOWN LN
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-3320
Practice Address - Country:US
Practice Address - Phone:516-457-8284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY449676-1251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health