Search icon

COASTAL COMMUNITY HEALTH SERVICES, INC. - Florida Company Profile

Company claim

Is this your business?

Get access!

Company Details

Entity Name: COASTAL COMMUNITY HEALTH SERVICES, INC.
Jurisdiction: FLORIDA
Filing Type: Foreign Non-Profit
Status: Active
Date Filed: 26 Mar 2024 (a year ago)
Document Number: F24000001903
FEI/EIN Number 461859206
Address: 22385 FLORA PARKE CROSSING, UNIT 2, LOT 2, FERNANDINA BEACH, FL, 32085, US
Mail Address: 22385 FLORA PARKE CROSSING, UNIT 2, LOT 2, FERNANDINA BEACH, FL, 32085, US
ZIP code: 32085
City: Saint Augustine
County: St. Johns
Place of Formation: GEORGIA

Key Officers & Management

Name Role Address
MUSTARI JEFFREY ESQ Agent 301 W BAY STREET, STE 14152, JACKSONVILLE, FL, 32202
CHANDLER KAVANAUGH Chief Executive Officer 100 PROFESSIONAL DRIVE, BRUNSWICK, GA, 31525
WHITE KARENA Chief Financial Officer 100 PROFESSIONAL DRIVE, BRUNSWICK, GA, 31525
BRAVO DAVID Secretary 100 LONG POINT, ST SIMONS ISLAND, GA, 31522
MATHIS FAYE Chairman 1502 SEMINOLE, WAYCROSS, GA, 31501
Smith LaQuite N Director 288 Gloucester Dr, Hinesville, GA, 31320

National Provider Identifier

NPI Number:
1184440463
Certification Date:
2025-05-14

Authorized Person:

Name:
DR. KAVANAUGH CHANDLER
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary:
Yes

Contacts:

Documents

Name Date
Foreign Non-Profit 2024-03-26

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 02 Aug 2025

Sources: Florida Department of State