Provider Demographics
NPI:1841923950
Name:SEACOAST OPCO LLC
Entity type:Organization
Organization Name:SEACOAST OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:COIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-564-5016
Mailing Address - Street 1:6367 BAY RD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-6501
Mailing Address - Country:US
Mailing Address - Phone:813-215-8080
Mailing Address - Fax:
Practice Address - Street 1:6367 BAY RD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-6501
Practice Address - Country:US
Practice Address - Phone:813-215-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities