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Organization

COASTAL EARLY INTERVENTION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONALD THAYER (OWNER AND EXECUTIVE DIRECTOR)
(843) 442-6940
Entity
Organization

Contact information

Practice address
2117 SHORT GRASS CT, MOUNT PLEASANT, SC 29466-8161
(843) 442-6940
Mailing address
2117 SHORT GRASS CT, MOUNT PLEASANT, SC 29466-8161

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
03/08/2019
Last updated
03/08/2019
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