Provider Demographics
NPI:1588966295
Name:WEST COAST LIVING, INC.
Entity type:Organization
Organization Name:WEST COAST LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:MAIO
Authorized Official - Last Name:MUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-474-6954
Mailing Address - Street 1:2301 MANASOTA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-6258
Mailing Address - Country:US
Mailing Address - Phone:941-474-6954
Mailing Address - Fax:941-474-6954
Practice Address - Street 1:2301 MANASOTA BEACH RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-6258
Practice Address - Country:US
Practice Address - Phone:941-474-6954
Practice Address - Fax:941-474-6954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL686313296253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL686313296OtherMED-WAIVER