NPIMap

Organization Active NPI

Coastal Home Care, LLC

  • In Home Supportive Care Agency
  • Brunswick, GA
National Provider Identifier
1942570676
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
063-R-0272 Issued in GA
Legal business name
COASTAL HOME CARE, LLC
Practice address
777 Gloucester St Ste 300
Brunswick, GA 31520-7068
Phone
(912) 264-5363
Fax
(912) 264-1845
NPI assigned
Jan 11, 2012
Last updated
Jun 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 063-R-0272 GA
In Home Supportive Care Agency 253Z00000X 063-R-0272 GA Primary

Addresses

Primary practice location

777 Gloucester St Ste 300
Brunswick, GA 31520-7068

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 1

IdentifierTypeStateIssuer
000552538AQMedicaidGA

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

3025 Altama Ave
Ste C
Brunswick, GA 31520
Phone (912) 264-5363

777 Gloucester St
Ste 300
Brunswick, GA 31520
Phone (912) 264-5363

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1942570676",
    "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": "912-352-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 GLOUCESTER ST STE 300",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207068",
            "telephone_number": "912-264-5363",
            "fax_number": "912-264-1845"
        }
    ],
    "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": "2012-01-11",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "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": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "063-R-0272",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "063-R-0272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000552538AQ",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.