Provider Demographics
NPI:1184354912
Name:COASTAL MIDWIFERY AND BEHAVIORAL HEALTH L L C
Entity type:Organization
Organization Name:COASTAL MIDWIFERY AND BEHAVIORAL HEALTH L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEARSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-868-7026
Mailing Address - Street 1:400 BELIEVERS LN NE
Mailing Address - Street 2:
Mailing Address - City:LUDOWICI
Mailing Address - State:GA
Mailing Address - Zip Code:31316-1718
Mailing Address - Country:US
Mailing Address - Phone:253-777-7501
Mailing Address - Fax:
Practice Address - Street 1:400 BELIEVERS LN NE
Practice Address - Street 2:
Practice Address - City:LUDOWICI
Practice Address - State:GA
Practice Address - Zip Code:31316-1718
Practice Address - Country:US
Practice Address - Phone:253-777-7501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center