Organization
COASTAL COMMUNITY CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE JEROME SMITH (MANAGER)
(910) 431-2996
Entity
Organization
Contact information
Practice address
1015 ASHES DR STE 202, WILMINGTON, NC 28405-8338
(910) 431-2996
Mailing address
1015 ASHES DR STE 202, WILMINGTON, NC 28405-8338
(910) 431-2996
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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