Organization
COASTAL CAROLINA BEHAVIORAL HEALTHCARE, LLC
Active
Other names
Circle of Courage Behavioral Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
LARONDA WOODS FREEMAN (EXECUTIVE DIRECTOR)
(910) 769-3575
Entity
Organization
Contact information
Practice address
108 HAY ST STE 303, FAYETTEVILLE, NC 28301-5684
(910) 769-3575
Mailing address
3806 PARK AVE STE A, WILMINGTON, NC 28403-6739
(910) 769-3575
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410191
—
NC
05
—
6008752
—
NC
05
—
6604437
—
NC
05
—
8301226
—
NC
05
—
8301226B
—
NC
05
—
8301226H
—
NC
05
—
8301226V
—
NC
Enumeration date
10/14/2013
Last updated
10/14/2013
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