# COASTAL COMMUNITY ACTION PROGRAM

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

## Provider details

- **NPI number:** 1356643316
- **Authorized official:** CRAIG L DUBLANKO (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (360) 533-5100

## Contact information

- **Practice address:** 117 E 3RD ST, ABERDEEN, WA 98520-4002
- **Practice address phone:** (360) 533-5100
- **Practice address fax:** (360) 532-4623
- **Mailing address:** 117 E 3RD ST, ABERDEEN, WA 98520-4002
- **Mailing address phone:** (360) 533-5100
- **Mailing address fax:** (360) 532-4623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 11/24/2010
- **Last updated:** 11/24/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7408222 | — | WA |