# COASTAL COMMUNITY CARE LLC

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

## Provider details

- **NPI number:** 1336772292
- **Authorized official:** CASSAUNDRA NANCE (OWNER)
- **Authorized official phone:** (850) 319-5693

## Contact information

- **Practice address:** 731 AIRPORT RD STE G, PANAMA CITY, FL 32405-4031
- **Practice address phone:** (850) 852-1058
- **Practice address fax:** (850) 852-1059
- **Mailing address:** 731 AIRPORT RD STE G, PANAMA CITY, FL 32405-4031
- **Mailing address phone:** (850) 852-1058
- **Mailing address fax:** (850) 852-1059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/19/2020
- **Last updated:** 06/11/2020