Coastal Residential Services, Inc

LBN: Coastal Residential Services, Inc
Coastal Residential Services, Inc is an health care organization with primary practice located at 445 Western Blvd Ste T , Jacksonville NC 28546-6852. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Agencies / Community/Behavioral Health is the primary health care specialty. Coastal Residential Services, Inc can be contacted via phone (910) 938-9550, or through Wilson, Carol via phone (910) 938-9550.

Contact Information

Primary practice address
445 Western Blvd Ste T Jacksonville NC 28546-6852
Phone: (910) 938-9550
Fax: (910) 346-9186
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Carol
Phone: (910) 938-9550

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X MHL-067-085 North Carolina
Agencies / Community/Behavioral Health 251S00000X MHL-067-052 North Carolina
Agencies / Community/Behavioral Health 251S00000X MHL-067-049 North Carolina
Agencies / Community/Behavioral Health 251S00000X MHL-067-059 North Carolina
Agencies / Community/Behavioral Health 251S00000X MHL-067-091 North Carolina
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X MHL-067-052 North Carolina
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X MHL-067049 North Carolina
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X MHL-067-059 North Carolina
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X MHL-067-091 North Carolina

Profile Details

NPI number 1780792705
LBN Legal business name Coastal Residential Services, Inc
DBA Doing business as
Authorized official Wilson, Carol
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2006
Last updated Nov 18th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780792705 NPPES
North Carolina MEDICAID 3419231
North Carolina MEDICAID 3408942

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