Coastal Quality Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COASTAL QUALITY ASSISTED LIVING, LLC

Practice address

804 Anita St
Fort Pierce, FL 34982-4006

Phone

(772) 242-1037

Fax

(772) 828-3514

NPI assigned

Jul 25, 2024

Organization subpart

No

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

Authorized official

Name

Loretta SmithNPI 1760263198

Title

Administrator/Owner

Phone

(772) 242-1037

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Loretta Smith

  • Assisted Living Facility
  • Fort Pierce, FL
  • NPI 1760263198
  NPD Authorized official

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1215765615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 ANITA ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349824006",
            "telephone_number": "772-242-1037",
            "fax_number": "772-828-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 ANITA ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349824006",
            "telephone_number": "772-242-1037",
            "fax_number": "772-828-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL QUALITY ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "772-242-1037"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristelle Alie Clemons, FNP
• Julie Diane Clute, ARNP
• Shenna Michelle Clyburn
• CMS Ft. Pierce
• Coastal Drip Mobile IV
• Coastal Wellness and Physiotherapy, LLC
• Daniel Cobbina
• Cocoa River Therapy, LLC
• Marc Ira Cohen, PHARMD
• Nathan Emanuel Cohen

• Assisted Living Facility in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.