Organization
COASTAL SENIOR CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY RENEE PETERSEN-SMITH (OWNER)
(843) 900-8903
Entity
Organization
Contact information
Practice address
1743 CENTRAL AVE, SUMMERVILLE, SC 29483-9321
(843) 900-8903
Mailing address
1743 CENTRAL AVE, SUMMERVILLE, SC 29483-9321
(843) 900-8903
(843) 628-3249
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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