# COASTAL COMMUNITY CARE, LLC

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

## Provider details

- **NPI number:** 1558167338
- **Authorized official:** MRS. JUDY MARIE SHREVE BSHA (OWNER)
- **Authorized official phone:** (757) 309-9223

## Contact information

- **Practice address:** 8220 ANDREW LN, NORFOLK, VA 23505-1612
- **Practice address phone:** (757) 309-9223
- **Mailing address:** 8220 ANDREW LN, NORFOLK, VA 23505-1612
- **Mailing address phone:** (757) 309-9223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |
| 251B00000X | Case Management Agency | — | NULL | — |

## Other

- **Enumeration date:** 02/21/2025
- **Last updated:** 04/23/2025