Coastal Community Care Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COASTAL COMMUNITY CARE SERVICES LLC

Practice address

1015 Ashes Dr Ste 202
Wilmington, NC 28405-8338

Phone

(910) 431-2996

NPI assigned

Sep 25, 2013

Last updated

Sep 25, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Eddie Jerome Smith

Title

Manager

Phone

(910) 431-2996

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1871929679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 ASHES DR STE 202",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284058338",
            "telephone_number": "910-431-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 ASHES DR STE 202",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284058338",
            "telephone_number": "910-431-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COMMUNITY CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "910-431-2996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Carolina Sedation Associates, LLC
• Coastal Childrens Services PLLC
• Coastal Childrens Services PLLC (CCS Wilmington)
• Coastal Childrens Services PLLC
• Coastal Chiropractic Center PA
• Coastal Connections Collective, PLLC
• Coastal Counseling Associates, PLLC
• Coastal Dermatology & Surgery Center, PA
• Coastal Enterprises of Wilmington
• Coastal Eyeworks Incorporated (Ogden Optical Center)

• Community/Behavioral Health Agency in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.