Provider Demographics
NPI:1881986461
Name:COAST FAMILY HOME CARE
Entity type:Organization
Organization Name:COAST FAMILY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-934-0600
Mailing Address - Street 1:2880 SANTA MARIA WAY STE D1
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-2172
Mailing Address - Country:US
Mailing Address - Phone:805-934-0600
Mailing Address - Fax:805-937-8969
Practice Address - Street 1:2880 SANTA MARIA WAY STE D1
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-2172
Practice Address - Country:US
Practice Address - Phone:805-934-0600
Practice Address - Fax:805-937-8969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care