Healthcare Provider Details

I. General information

NPI: 1356580674
Provider Name (Legal Business Name): COASTAL HORIZONSCENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL CAMPUS DR SUITE 103
SUPPLY NC
28462-4096
US

IV. Provider business mailing address

615 SHIPYARD BLVD
WILMINGTON NC
28412-6431
US

V. Phone/Fax

Practice location:
  • Phone: 910-754-4515
  • Fax: 910-754-9997
Mailing address:
  • Phone: 910-343-0145
  • Fax: 910-341-5779

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: MS. MARGARET WELLER-STARGELL
Title or Position: PRESIDENT/CEO
Credential:
Phone: 910-790-0187