NPIMap

Organization Active NPI

Coastal Home Care, LLC

  • In Home Supportive Care Agency
  • Savannah, GA
National Provider Identifier
1043576929
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
COASTAL HOME CARE, LLC
Practice address
6602 Abercorn St Ste 200
Savannah, GA 31405-5849
Phone
(912) 354-3680
NPI assigned
Apr 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Joseph Bonaccorsi
Title
Chief Legal Officer
Phone
(312) 762-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

6602 Abercorn St Ste 200
Savannah, GA 31405-5849

Mailing address

33 S State St FL 5
Chicago, IL 60603-2804
Phone (312) 762-9999

Other identifiers 1

IdentifierTypeStateIssuer
000609958ASMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Coastal Home Care LLC29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1043576929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S STATE ST FL 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032804",
            "telephone_number": "312-762-9999",
            "fax_number": "912-355-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6602 ABERCORN ST STE 200",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055849",
            "telephone_number": "912-354-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-05",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "BONACCORSI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "312-762-9999"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000609958AS",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.