Provider Demographics
NPI:1396154886
Name:GULF COAST TOTALCARE
Entity type:Organization
Organization Name:GULF COAST TOTALCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-476-5656
Mailing Address - Street 1:3280 DAUPHIN ST
Mailing Address - Street 2:BUILDING C, SUITE 115
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4060
Mailing Address - Country:US
Mailing Address - Phone:251-476-5656
Mailing Address - Fax:251-476-5155
Practice Address - Street 1:3280 DAUPHIN ST
Practice Address - Street 2:BUILDING C, SUITE 115
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4060
Practice Address - Country:US
Practice Address - Phone:251-476-5656
Practice Address - Fax:251-476-5155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management