Coastal Concierge Services LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

COASTAL CONCIERGE SERVICES LLC

Practice address

2690 SE Willoughby Blvd
Stuart, FL 34994-4700

Phone

(772) 485-8931

NPI assigned

Jun 27, 2016

Last updated

Jun 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Eckstrom

Title

Manager

Phone

(772) 485-8931

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1144671553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944700",
            "telephone_number": "772-485-8931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944700",
            "telephone_number": "772-485-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CONCIERGE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "ECKSTROM",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "772-485-8931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOCUMENT NUMBER",
            "identifier": "L16000112704",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Stuart, FL
• Providers in Stuart, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.