Provider Demographics
NPI:1730383621
Name:COASTAL GEORGIA AREA CAA. INC
Entity type:Organization
Organization Name:COASTAL GEORGIA AREA CAA. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:ETC
Authorized Official - Phone:912-264-3281
Mailing Address - Street 1:1 COMMUNITY ACTION DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-3783
Mailing Address - Country:US
Mailing Address - Phone:912-264-3281
Mailing Address - Fax:912-265-7444
Practice Address - Street 1:1 COMMUNITY ACTION DR
Practice Address - Street 2:SUITE A
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-3783
Practice Address - Country:US
Practice Address - Phone:912-264-3281
Practice Address - Fax:912-265-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2565332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals