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Organization

COASTAL HOME CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH BONACCORSI (CHIEF LEGAL OFFICER)
(312) 762-9999
Entity
Organization

Contact information

Practice address
1309 VIRGINIA ST, COLUMBUS, GA 31901-2569
(706) 400-4396
Mailing address
33 S STATE ST FL 5, CHICAGO, IL 60603-2804
(312) 762-9999
(912) 352-9601

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
333300000X
Emergency Response System Companies
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000552538BO
GA
Enumeration date
01/25/2012
Last updated
04/29/2025
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