Provider Demographics
NPI:1700361821
Name:COASTAL NURSING ASSISTANT
Entity Type:Organization
Organization Name:COASTAL NURSING ASSISTANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VCITORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-643-4181
Mailing Address - Street 1:6842 RICHARD LN
Mailing Address - Street 2:
Mailing Address - City:EIGHT MILE
Mailing Address - State:AL
Mailing Address - Zip Code:36613-9650
Mailing Address - Country:US
Mailing Address - Phone:251-643-4181
Mailing Address - Fax:
Practice Address - Street 1:6842 RICHARD LN
Practice Address - Street 2:
Practice Address - City:EIGHT MILE
Practice Address - State:AL
Practice Address - Zip Code:36613-9650
Practice Address - Country:US
Practice Address - Phone:251-643-4181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home