Provider Demographics
NPI:1992862122
Name:WESTCOAST ACCESS TO CHILDREN'S HEALTH INC.
Entity Type:Organization
Organization Name:WESTCOAST ACCESS TO CHILDREN'S HEALTH INC.
Other - Org Name:WATCH PRIMARY CARE PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:PROJECT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:941-361-6250
Mailing Address - Street 1:6055 RAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-5189
Mailing Address - Country:US
Mailing Address - Phone:941-361-6250
Mailing Address - Fax:941-373-7420
Practice Address - Street 1:6055 RAND BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5189
Practice Address - Country:US
Practice Address - Phone:941-361-6250
Practice Address - Fax:941-373-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLN51258163WP0200X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty
Not Answered251B00000XAgenciesCase Management