Provider Demographics
NPI:1922781350
Name:COAST TO COAST MHS, LLC
Entity Type:Organization
Organization Name:COAST TO COAST MHS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-652-0260
Mailing Address - Street 1:223 E OAK ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-4445
Mailing Address - Country:US
Mailing Address - Phone:239-652-0260
Mailing Address - Fax:239-652-0146
Practice Address - Street 1:223 E OAK ST APT 3
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-4445
Practice Address - Country:US
Practice Address - Phone:239-652-0260
Practice Address - Fax:239-652-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty