# COASTAL EARLY INTERVENTION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285192245
- **Authorized official:** RONALD THAYER (OWNER AND EXECUTIVE DIRECTOR)
- **Authorized official phone:** (843) 442-6940

## Contact information

- **Practice address:** 2117 SHORT GRASS CT, MOUNT PLEASANT, SC 29466-8161
- **Practice address phone:** (843) 442-6940
- **Mailing address:** 2117 SHORT GRASS CT, MOUNT PLEASANT, SC 29466-8161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/08/2019
- **Last updated:** 03/08/2019