Provider Demographics
NPI:1154568814
Name:CENTRAL COAST HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:CENTRAL COAST HEALTHCARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DPCS/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSN, PHN
Authorized Official - Phone:818-852-7260
Mailing Address - Street 1:346 KANAN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-1152
Mailing Address - Country:US
Mailing Address - Phone:818-852-7260
Mailing Address - Fax:818-852-7259
Practice Address - Street 1:346 KANAN RD STE 202
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-1152
Practice Address - Country:US
Practice Address - Phone:818-852-7260
Practice Address - Fax:818-852-7259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based