COASTAL COMMUNITY CARE SERVICES, INC (NPI# 1811325392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811325392 |
| Entity Type | Organization |
| Organization Name | COASTAL COMMUNITY CARE SERVICES, INC |
| Practice Address |
4615 North Fwy Ste 204 Houston TX 77022-2920 |
| Practice Telephone | 7136940051 |
| Practice Fax Number | 7136944711 |
| Mailing Telephone | 7136940051 |
| Mailing Fax Number | 7136944711 |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2013-10-21 |
| Authorized Official Name | MR. HYACINTH M CHIEDU (DIRECTOR) |
| Authorized Official Telephone | 7136940051 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 001008928 | TX | Residential Treatment Facilities |
| Street Address |
4615 NORTH FWY STE 204 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77022-2920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831266287 | Healthline Rehab & Medical Clinic, Inc | Durable Medical Equipment & Medical Supplies | 4615 North Fwy Ste 204, #106, Houston, TX 77022-2920 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700418373 | Magnolia 1 House | Nursing Care | 505 E 38th St, Houston, TX 77022 | 2020-02-11 |
| 1720569429 | Loving Care Assisted Living Home | Assisted Living Facility | 8209 N Main St, Houston, TX 77022 | 2018-08-22 |
| 1235687674 | Elizabeth Brooke Avant | Physical Therapist | 5206 Airline Drive, Houston, TX 77022 | 2016-09-14 |
| 1225407109 | Elsa Murillo | Pharmacy Technician | 4712 Airline Drive, Suite F, Houston, TX 77022 | 2015-09-21 |
| 1215210125 | Tidwell Rx LLC | Pharmacy | 712 E Tidwell Rd, Suite C, Houston, TX 77022 | 2011-09-27 |
| 1184904195 | Victoria Ann Ramirez | Dentist | 4400 North Fwy Spc D500, Houston, TX 77022 | 2011-08-22 |
| 1902116726 | Serrot Inc. | Optometrist | 4412 North Freeway, Houston, TX 77022 | 2010-10-14 |
| 1972811586 | Wal-mart Stores Texas LLC | Technician/Technologist | 4412 N Fwy, Houston, TX 77022 | 2010-09-16 |
| 1922329671 | Hamid S Sohrabian | Chiropractor | 4615 North Frwy . 208, Houston, TX 77022 | 2010-06-17 |
| 1861636896 | Johnnetta Matrice Nichols | Assisted Living Facility | 8209 N. Main St., Houston, TX 77022 | 2009-04-21 |
| Find all providers in zip 77022 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285253856 | 1 Care Premier Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 340 N Sam Houston Pkwy E Ste A247, Houston, TX 77060-3305 | 2020-04-13 |
| 1144877481 | Boniswa Portia Maduna | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8000 Cook Rd Apt 1109, Houston, TX 77072-3939 | 2019-08-21 |
| 1376104653 | Ladies Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2525 Winrock Blvd Apt 122, Houston, TX 77057-4325 | 2019-06-26 |
| 1366005712 | Cogic | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7809 Winship St, Houston, TX 77028-2441 | 2019-04-20 |
| 1891257382 | Amazing Grace Greater Homes LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9231 Floral Crest Dr, Houston, TX 77083-6226 | 2019-04-03 |
| 1083172092 | Silver Lining Residential,llc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8014 Montague Manor Ln, Houston, TX 77072-0124 | 2019-03-08 |
| 1922570712 | Katrina Williams | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12214 Plumpoint Dr, Houston, TX 77099-3138 | 2018-12-18 |
| 1902376635 | Friendly Angels LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 15403 Town Green Dr, Houston, TX 77083-5539 | 2018-11-26 |
| 1851869358 | Wavuli Foundation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8542 Village Rose Ln, Houston, TX 77072-5649 | 2018-11-02 |
| 1083197966 | C&d Amazing Care Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 15226 Mission Forest Dr, Houston, TX 77083-7359 | 2018-09-07 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.