Provider Demographics
NPI:1649518994
Name:COASTAL HEALTHCARE SOLUTIONS
Entity type:Organization
Organization Name:COASTAL HEALTHCARE SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIVISIONAL PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-689-2774
Mailing Address - Street 1:2505 METROCENTRE BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3114
Mailing Address - Country:US
Mailing Address - Phone:561-689-2774
Mailing Address - Fax:561-491-0400
Practice Address - Street 1:2505 METROCENTRE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3114
Practice Address - Country:US
Practice Address - Phone:561-689-2774
Practice Address - Fax:561-491-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health