# COASTAL COMMUNITY CARE SERVICES, INC

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

## Provider details

- **NPI number:** 1811325392
- **Authorized official:** MR. HYACINTH M CHIEDU (DIRECTOR)
- **Authorized official phone:** (713) 694-0051

## Contact information

- **Practice address:** 4615 NORTH FWY STE 204, HOUSTON, TX 77022-2920
- **Practice address phone:** (713) 694-0051
- **Practice address fax:** (713) 694-4711
- **Mailing address:** 4615 NORTH FWY STE 204, HOUSTON, TX 77022-2920
- **Mailing address phone:** (713) 694-0051
- **Mailing address fax:** (713) 694-4711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 001008928 | TX | Yes |

## Other

- **Enumeration date:** 10/21/2013
- **Last updated:** 10/21/2013