| Organization Name: | COASTAL OAKS HOMECARE INC |
| NPI Number: | 1104151000 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDRA E YATES (DIRECTOR) |
| Mailing Address: | 3869 S Nova Rd Unit 2 Port Orange |
| State: | FL US |
| Postal Code: | 321274246 |
| Phone Number: | 3863229375 |
| Fax Number: | 3867617804 |
| NPI Enumeration Date: | 10/09/2009 |
| NPI Last Update Date: | 10/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 30211232 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |