| Coastal Horizons Center, Inc. | |
|
615 Shipyard Blvd Wilmington NC 28412-6431 | |
| (910) 790-0187 | |
| (910) 790-0189 |
| Full Name | Coastal Horizons Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 615 Shipyard Blvd, Wilmington, North Carolina |
| Authorized Official Name and Position | Eric James Luttmer (VP CORPORATE COMPLIANCE) |
| Authorized Official Contact | 9103430145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Horizons Center, Inc. 615 Shipyard Blvd Wilmington NC 28412-6431 Ph: (910) 790-0187 | Coastal Horizons Center, Inc. 615 Shipyard Blvd Wilmington NC 28412-6431 Ph: (910) 790-0187 |
| NPI Number | 1831333467 |
|---|---|
| Provider Enumeration Date | 04/27/2009 |
| Last Update Date | 06/10/2020 |
| Certification Date | 06/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831333467 | NPI | - | NPPES |
| 6005343 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | MHL-065-011 (North Carolina) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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