| Coastal Carolina Psychiatric Services Pllc | |
|
1708 Lakeside Dr Nw Wilson NC 27896-1800 | |
| (252) 265-9680 | |
| (252) 265-9680 |
| Full Name | Coastal Carolina Psychiatric Services Pllc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1708 Lakeside Dr Nw, Wilson, North Carolina |
| Authorized Official Name and Position | Bush Kavuru (MEMBER-MANAGER) |
| Authorized Official Contact | 2522659680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Carolina Psychiatric Services Pllc 1708 Lakeside Dr Nw Wilson NC 27896-1800 Ph: (252) 265-9680 | Coastal Carolina Psychiatric Services Pllc 1708 Lakeside Dr Nw Wilson NC 27896-1800 Ph: (252) 265-9680 |
| NPI Number | 1598807430 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598807430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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