Provider Demographics
NPI:1386425940
Name:COASTAL CAREGIVERS LLC.
Entity type:Organization
Organization Name:COASTAL CAREGIVERS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGETTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOULSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-200-2629
Mailing Address - Street 1:20 COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3813
Mailing Address - Country:US
Mailing Address - Phone:251-517-2243
Mailing Address - Fax:251-210-4405
Practice Address - Street 1:20 COTTAGE DR
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3813
Practice Address - Country:US
Practice Address - Phone:251-517-2243
Practice Address - Fax:251-210-4405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care