South Coast Home LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

SOUTH COAST HOME LLC

Practice address

72633 M 43
South Haven, MI 49090-8734

Phone

(269) 998-9349

NPI assigned

May 25, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Chester Kwiatkowski

Title

Licensee/Owner

Phone

(269) 998-9349

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1033776919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29",
            "city": "MACATAWA",
            "state": "MI",
            "postal_code": "494340029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72633 M 43",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490908734",
            "telephone_number": "269-998-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-25",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "KWIATKOWSKI",
        "authorized_official_first_name": "CHESTER",
        "authorized_official_title_or_position": "LICENSEE/OWNER",
        "authorized_official_telephone_number": "269-998-9349",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Slachta, PA-C
• Matthew G Small, MD
• Scott Eric Smith, OTR
• Soma Medical Clinic, LLC
• Alisa A Somers, DPT
• South Haven Area Emergency Services Authority
• South Haven Chiropractic Clinic
• South Haven Community Health System
• South Haven Eyecare Associates
• South Haven Family Physicians, P.C.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in South Haven, MI
• Providers in South Haven, MI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.