# COASTAL BAY HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastal Bay Health Services LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508160136
- **Authorized official:** MR. SHAWN THORPE (SOLE MEMBER)
- **Authorized official phone:** (336) 414-7504

## Contact information

- **Practice address:** 10151 DEERWOOD PARK BLVD BLDG 200, SUITE 250, JACKSONVILLE, FL 32256-0566
- **Practice address phone:** (336) 414-7504
- **Mailing address:** 10151 DEERWOOD PARK BLVD BLDG 200, SUITE 250, JACKSONVILLE, FL 32256-0566
- **Mailing address phone:** (336) 414-7504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/22/2010
- **Last updated:** 12/22/2010