Provider Demographics
NPI:1174019426
Name:COASTAL HORIZONS CENTER
Entity Type:Organization
Organization Name:COASTAL HORIZONS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY IMPROVEMENT TRAINING DIR.
Authorized Official - Prefix:MR
Authorized Official - First Name:TALMADGE
Authorized Official - Middle Name:LINDSAY
Authorized Official - Last Name:JOINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-202-5709
Mailing Address - Street 1:120 COASTAL HORIZONS DR
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-6094
Mailing Address - Country:US
Mailing Address - Phone:910-754-4515
Mailing Address - Fax:910-754-7997
Practice Address - Street 1:120 COASTAL HORIZONS DR
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-6094
Practice Address - Country:US
Practice Address - Phone:910-754-4515
Practice Address - Fax:910-754-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health