Provider Demographics
NPI:1821504465
Name:COASTAL HORIZONS CENTER INC.
Entity Type:Organization
Organization Name:COASTAL HORIZONS CENTER INC.
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:JR
Authorized Official - Credentials:
Authorized Official - Phone:910-202-5709
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:910-341-5709
Practice Address - Street 1:613 SHIPYARD BOULEVARD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6492
Practice Address - Country:US
Practice Address - Phone:910-769-1095
Practice Address - Fax:910-769-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC800416QMedicaid
NC8300416HMedicaid
NC8301322QMedicaid
NC8302795QMedicaid
NC8301322HMedicaid
NC3410030Medicaid
NC8300416Medicaid
NC8300416TMedicaid