NPIMap

Organization Active NPI

Coastal Home Care, LLC

  • Home Health Agency
  • Duluth, GA
National Provider Identifier
1619318052
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
085-R-1045 Issued in GA
Legal business name
COASTAL HOME CARE, LLC
Practice address
3805 Crestwood Pkwy NW Ste 320
Duluth, GA 30096-7164
Phone
(470) 617-9401
NPI assigned
Jul 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 085-R-1045 GA Primary
Home Health Agency 251E00000X
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

3805 Crestwood Pkwy NW Ste 320
Duluth, GA 30096-7164

Mailing address

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

Other practice location 1

1149 Cornell Ave Ste 1A
Savannah, GA 31406-2757
Phone (912) 354-3680

Other identifiers 3

IdentifierTypeStateIssuer
370024140AMedicaidGA
060-R-0226OtherGAPERMIT
000552538CCMedicaidGA

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

Locations

3805 Crestwood Pkwy NW
Ste 320
Duluth, GA 30096

3885 Crestwood Pkwy NW
Ste 375
Duluth, GA 30096
Phone (470) 617-9401

6602 Abercorn St
Ste 200
Savannah, GA 31405
Phone (912) 354-3680

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1619318052",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 CRESTWOOD PKWY NW STE 320",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300967164",
            "telephone_number": "470-617-9401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1149 Cornell Ave Ste 1A",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314062757",
            "country_code": "US",
            "telephone_number": "912-354-3680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "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": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "085-R-1045",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370024140A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERMIT",
            "identifier": "060-R-0226",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000552538CC",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.