Organization · NPI-2

Coastal Atlantic Residential Adult Personal Care Home

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Savannah, GA

NPI number1952208589
StatusActive
Last updated in NPPESOct 26, 2026

Details

NPI
1952208589
Entity type
Organization (NPI-2)
Legal business name
Coastal Atlantic Residential Adult Personal Care Home
Organization subpart
No
Enumeration date
Oct 26, 2026
Certification date
Oct 22, 2026
Last updated
Oct 26, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities––Yes

Other names

  • Coastal Atlantic Residential Adult Pch 2 (Other Name)

Practice location

2104 California Ave
Savannah, GA 31404-2603

Phone 912-963-7190

Mailing address

177 Cherry Laural Ln
Savannah, GA 31419-9495

Phone 912-313-8276

Other practice locations

5005 Jasmine Ave
Savannah, GA 31404-6006

Phone 912-963-7190

Authorized official

Leonard Keith Mccoy
Administrator
9129637190

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