Organization
COASTAL CAROLINA HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENELL LYNN SIKES (DIRECTOR / OWNER)
(910) 754-3445
Entity
Organization
Contact information
Practice address
117 HOLDEN BEACH RD., SUITE 101, SHALLOTTE, NC 28459
(910) 754-3445
(910) 754-3446
Mailing address
PO BOX 3291, SHALLOTTE, NC 28459-3291
(910) 754-3445
(910) 754-3446
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HC3013
NC
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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