Provider Demographics
NPI:1902462450
Name:ADVANCED COASTAL THERAPY
Entity Type:Organization
Organization Name:ADVANCED COASTAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OT
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BASINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-321-8341
Mailing Address - Street 1:71 PLANTATION HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4774
Mailing Address - Country:US
Mailing Address - Phone:843-321-8341
Mailing Address - Fax:843-706-9050
Practice Address - Street 1:71 PLANTATION HOUSE DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-4774
Practice Address - Country:US
Practice Address - Phone:843-321-8341
Practice Address - Fax:843-706-9050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty