Coastal Residential Services, Inc | |
445 Western Blvd Ste T Jacksonville NC 28546-6852 | |
(910) 938-9550 | |
(910) 346-9186 |
Full Name | Coastal Residential Services, Inc |
---|---|
Speciality | Community/behavioral Health |
Location | 445 Western Blvd Ste T, Jacksonville, North Carolina |
Authorized Official Name and Position | Carol Wilson (VICE PRESIDENT) |
Authorized Official Contact | 9109389550 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Coastal Residential Services, Inc Po Box 7128 Jacksonville NC 28540-2128 Ph: (910) 938-9550 | Coastal Residential Services, Inc 445 Western Blvd Ste T Jacksonville NC 28546-6852 Ph: (910) 938-9550 |
NPI Number | 1780792705 |
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Provider Enumeration Date | 08/29/2006 |
Last Update Date | 11/18/2020 |
Certification Date | 11/18/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780792705 | NPI | - | NPPES |
3419231 | Medicaid | NC | |
3408942 | Medicaid | NC |
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