| Organization Name: | COASTSIDE ADULT DAY HEALTH CENTER |
| NPI Number: | 1568503282 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANIE BONO (EXECUTIVE DIRECTOR) |
| Mailing Address: | 645 Correas St Half Moon Bay |
| State: | CA US |
| Postal Code: | 940191962 |
| Phone Number: | 6507265067 |
| Fax Number: | 6507268743 |
| NPI Enumeration Date: | 02/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |