Organization
COAST TO COAST HEALTHCARE SOLUTIONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUDY JACKSON (PRESIDENT)
(305) 999-9295
Entity
Organization
Contact information
Practice address
4700 N STATE ROAD 7 STE A-101, LAUDERDALE LAKES, FL 33319-5800
(954) 667-1125
(954) 667-1130
Mailing address
4700 N STATE ROAD 7, SUITE A-101, LAUDERDALE LAKES, FL 33319-5800
(954) 667-1125
(954) 667-1130
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
30211118
FL
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
687228004
MEDICAID WAIVER
FL
05
—
687228006
—
FL
Enumeration date
06/22/2015
Last updated
03/09/2022
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