Healthcare Provider Details

I. General information

NPI: 1629904768
Provider Name (Legal Business Name): COASTAL HORIZONS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717-C GREENWAY RD.
BOONE NC
28607-4991
US

IV. Provider business mailing address

717-C GREENWAY RD.
BOONE NC
28607-4991
US

V. Phone/Fax

Practice location:
  • Phone: 910-202-3155
  • Fax:
Mailing address:
  • Phone: 910-343-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TALMADGE LINDSAY JOINES JR.
Title or Position: QI TRAINING DIR./OTP SPONSOR
Credential:
Phone: 910-685-0283