# COASTAL CARE SERVICES LLC

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

## Provider details

- **NPI number:** 1437609583
- **Authorized official:** BARRY LOUIS GROS JR. (OWNER)
- **Authorized official phone:** (504) 616-7902

## Contact information

- **Practice address:** 105 PARK DR, THIBODAUX, LA 70301-6426
- **Practice address phone:** (504) 616-7902
- **Mailing address:** 105 CAMPBELL BLVD STE 1, MANDEVILLE, LA 70471-1912
- **Mailing address phone:** (985) 900-2115
- **Mailing address fax:** (985) 900-2116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/12/2016
- **Last updated:** 12/07/2016