Provider Demographics
NPI:1902688773
Name:COASTAL FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:COASTAL FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BOWHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-567-0195
Mailing Address - Street 1:1642 PLEASURE HOUSE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4050
Mailing Address - Country:US
Mailing Address - Phone:757-216-1934
Mailing Address - Fax:757-793-3440
Practice Address - Street 1:1642 PLEASURE HOUSE RD STE 104
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-4050
Practice Address - Country:US
Practice Address - Phone:757-216-1934
Practice Address - Fax:757-793-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care