Provider Demographics
NPI:1821586918
Name:COASTAL HORIZONS CENTER INC.
Entity type:Organization
Organization Name:COASTAL HORIZONS CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:QUALITY IMPROVEMENT TRAINING DIRECT
Authorized Official - Prefix:
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 1:1496 HWY 701 S.
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-7700
Mailing Address - Country:US
Mailing Address - Phone:910-862-4071
Mailing Address - Fax:
Practice Address - Street 1:COASTAL HORIZONS CENTER, INC. - BLADEN DAY TREATMENT
Practice Address - Street 2:1496 HWY 701 S.
Practice Address - City:ELIZABETHTOWN,
Practice Address - State:NC
Practice Address - Zip Code:28337
Practice Address - Country:US
Practice Address - Phone:910-862-4071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3410030Medicaid