Provider Demographics
NPI:1700348554
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:910-341-5779
Practice Address - Street 1:110 PREMIERE PLZ
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-2522
Practice Address - Country:US
Practice Address - Phone:910-202-3155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health