Organization
COASTAL FAMILY HEALTH CENTER, INC
Active
Organization
COASTAL FAMILY HEALTH CENTER, INC
Active
Other names
Coastal Family Health Center, Inc - Lucedale Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELIQUE GREER (CEO)
(228) 374-2494
Entity
Organization
Contact information
Practice address
11231 OLD 63 S, LUCEDALE, MS 39452-4941
(228) 374-2494
Mailing address
10467 CORPORATE DR, GULFPORT, MS 39503-4634
(228) 374-2494
(228) 374-2713
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
08/16/2024
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