Organization
COASTAL COMMUNITY MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN ANDREW TRAYLOR LPCA (PRESIDENT)
(910) 499-3510
Entity
Organization
Contact information
Practice address
725 WEDGEWOOD RD, WHITEVILLE, NC 28472-2928
(910) 499-3510
Mailing address
725 WEDGEWOOD RD, WHITEVILLE, NC 28472-2928
(910) 499-3510
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A9883
NC
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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