# COASTAL HOME CARE, LLC

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

## Provider details

- **NPI number:** 1710258587
- **Authorized official:** JOSEPH BONACCORSI (CHIEF LEGAL OFFICER)
- **Authorized official phone:** (312) 762-9999

## Contact information

- **Practice address:** 6602 ABERCORN ST STE 200, SAVANNAH, GA 31405-5849
- **Practice address phone:** (912) 354-3680
- **Mailing address:** 33 S STATE ST FL 5, CHICAGO, IL 60603-2804
- **Mailing address phone:** (312) 762-9999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | 016-R-0270 | GA | — |
| 253Z00000X | In Home Supportive Care Agency | 016-R-0270 | GA | Yes |

## Other

- **Enumeration date:** 01/25/2012
- **Last updated:** 09/14/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000552538AM | — | GA |