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Organization

COASTALCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GLENNA HARFORD (CFO)
(910) 550-2567
Entity
Organization

Contact information

Practice address
3809 SHIPYARD BLVD, WILMINGTON, NC 28403-6150
(910) 550-2600
(910) 550-2570
Mailing address
P.O. BOX 4147, WILMINGTON, NC 28406-1147
(910) 550-2600
(910) 550-2570

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MHL 065-007
NC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
MHL065007
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3404933
NC
05
3408379
NC
Enumeration date
12/08/2006
Last updated
08/21/2013
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