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Organization
COASTAL EARLY INTERVENTION LLC
Active
Organization
COASTAL EARLY INTERVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD THAYER (OWNER AND EXECUTIVE DIRECTOR)
(843) 442-6940
Entity
Organization
Contact information
Practice address
2117 SHORT GRASS CT, MOUNT PLEASANT, SC 29466-8161
(843) 442-6940
Mailing address
2117 SHORT GRASS CT, MOUNT PLEASANT, SC 29466-8161
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NULL
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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