Provider Demographics
NPI:1184056723
Name:COASTAL BEND HOME HEALTH LLC
Entity type:Organization
Organization Name:COASTAL BEND HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:DOZIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:361-944-2847
Mailing Address - Street 1:626 MCCLENDON ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2623
Mailing Address - Country:US
Mailing Address - Phone:361-944-2847
Mailing Address - Fax:
Practice Address - Street 1:626 MCCLENDON ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2623
Practice Address - Country:US
Practice Address - Phone:361-944-2847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-06
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care