Organization
COASTAL QUALITY ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA SMITH (ADMINISTRATOR/OWNER)
(772) 242-1037
Entity
Organization
Contact information
Practice address
804 ANITA ST, FORT PIERCE, FL 34982-4006
(772) 242-1037
(772) 828-3514
Mailing address
804 ANITA ST, FORT PIERCE, FL 34982-4006
(772) 242-1037
(772) 828-3514
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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