Coastal Cove of Kenansville LLC
NPI #1316670961 in Kenansville, North Carolina
Provider Information
- NPI Number
- 1316670961
- Entity Type
- Organization
- Organization Name
- Coastal Cove of Kenansville LLC
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Jul 1, 2022
- Last Updated
- Jul 13, 2022
Practice Location
- Address
- 329 COOPER STREET
- City
- Kenansville
- State
- North Carolina
- ZIP Code
- 28349-2260
- Phone
- (520) 437-1635
Authorized Official
- Name
- RAMARAJ RADHAKRISHNAN, MD
- Title
- OWNER
- Phone
- (520) 437-1635
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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