Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Coastal Residential Services, Inc

Organization Community/Behavioral Health Agency · NPI 1780792705

Coastal Residential Services, Inc is a Community/Behavioral Health Agency in Jacksonville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
Specialties on file
9
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

445 Western Blvd Ste T
Jacksonville, NC 28546-6852
Phone: (910) 938-9550
Fax: (910) 346-9186
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X · Licence MHL-067-085 (NC)
Community/Behavioral Health Agency Taxonomy 251S00000X · Licence MHL-067-052 (NC)
Community/Behavioral Health Agency Taxonomy 251S00000X · Licence MHL-067-049 (NC)
Community/Behavioral Health Agency Taxonomy 251S00000X · Licence MHL-067-059 (NC)
Community/Behavioral Health Agency Taxonomy 251S00000X · Licence MHL-067-091 (NC)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X · Licence MHL-067-052 (NC)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X · Licence MHL-067049 (NC)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X · Licence MHL-067-059 (NC)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X · Licence MHL-067-091 (NC)

Record details

NPI number1780792705
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carol Wilson — Vice President · (910) 938-9550
NPI enumeratedAugust 29, 2006
Last updated in NPPESNovember 18, 2020
Certification dateNovember 18, 2020
Mailing addressPo Box 7128, Jacksonville, NC 28540-2128

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