MEDICARE: COASTAL HORIZONS CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1063082592
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL HORIZONS CENTER INC

Provider Business Mailing Address
First Line	:	7910 US HWY 117 S
Second Line	:
City	:	ROCKY POINT
State	:	NC
Zip	:	28457-9431
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7910 US HWY 117 S
Second Line	:
City	:	ROCKY POINT
State	:	NC
Zip	:	28457-9431
Country	:	US
Telephone Number	:	910-343-0145
Fax Number	:

Authorized Official
Title or Position	:	QI TRAINING DIR./OTP SPONSOR
Name	:	LINDSAY LINDSAY JOINES
Credential	:
Telephone Number	:	910-685-0283

Provider Enumeration Date	:	06/28/2021
Last Update Date	:	06/28/2021

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Directions to “COASTAL HORIZONS CENTER INC ” Practice Location

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