Emerald Coast Healthcare, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

EMERALD COAST HEALTHCARE, LLC

Doing business as

Emerald Coast Congregate

Practice address

3495 Jefferson St
Riverside, CA 92504-3519

Phone

(949) 397-0658

NPI assigned

Jun 21, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Adam Cortland Green

Title

Owner

Phone

(949) 397-0658

Specialties & licenses 1

Addresses

Other names 1

• Emerald Coast Congregate Doing business as

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1093384489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 CROWN VALLEY PKWY STE D4",
            "address_2": "BOX 151",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926940613",
            "telephone_number": "949-397-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 JEFFERSON ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925043519",
            "telephone_number": "949-397-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "CORTLAND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-397-0658",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Coast Congregate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Omar Elsemary, MD
• Najla Emadi
• Aras Emdadi, DO
• Ariana Emde
• Stephanie Pim Emde
• Emerald Isle Medical Group Inc
• Emergency Surgical Associates
• Neisha Emerson, P.T.
• Iheanacho Emeruwa, M.D.
• Alison Emery

• Nursing Facility/Intermediate Care Facility in Riverside, CA
• Providers in Riverside, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.