Organization
COASTAL COVE OF KENANSVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMARAJ RADHAKRISHNAN MD (OWNER)
(520) 437-1635
Entity
Organization
Contact information
Practice address
329 COOPER STREET, KENANSVILLE, NC 28349-2260
(520) 437-1635
Mailing address
8480 HONEYCUTT RD STE 200-V88, RALEIGH, NC 27615-2260
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
07/13/2022
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