Provider Demographics
NPI:1619568763
Name:COASTAL HORIZONS CENTER INC
Entity Type:Organization
Organization Name:COASTAL HORIZONS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QI TRAINING DIRECTOR
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:910-399-3755
Mailing Address - Street 1:615 SHIPYARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6431
Mailing Address - Country:US
Mailing Address - Phone:910-343-0145
Mailing Address - Fax:910-341-5779
Practice Address - Street 1:4005 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6816
Practice Address - Country:US
Practice Address - Phone:910-790-0949
Practice Address - Fax:910-790-9455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health