COASTAL ENTERPRISES OF WILMINGTON (NPI# 1053453258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053453258 |
| Entity Type | Organization |
| Organization Name | COASTAL ENTERPRISES OF WILMINGTON |
| Practice Address |
1214 Kidder St Wilmington NC 28401-5918 |
| Practice Telephone | 9107633424 |
| Practice Fax Number | 9108150367 |
| Mailing Telephone | 9107633424 |
| Mailing Fax Number | 9108150367 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2019-03-07 |
| Authorized Official Name | MR. DONALD LEON HOOVER (IDD SERVICES COORDINATOR) |
| Authorized Official Telephone | 9107633424 |
| Authorized Official Credential | BS, QP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | MHL-065-099 | NC | Agencies |
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MENTAL HEALTH LICENSE # | MHL-065-099 | 01 |
| Street Address |
1214 KIDDER ST |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-5918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891307070 | Aviva Health Care Services Inc | Community/Behavioral Health | 6 Denny Rd Ste 104, Wilmington, DE 19809-3444 | 2020-08-19 |
| 1679192926 | Wraparound Maryland, Inc | Community/Behavioral Health | 105 Rogers Rd Ste A, Wilmington, DE 19801-5619 | 2020-04-15 |
| 1457983165 | Alapocas Collaborative Care, LLC | Community/Behavioral Health | 1601 Concord Pike Ste 66-68, Wilmington, DE 19803-3612 | 2020-02-11 |
| 1477011211 | M&l Prodigy Healthcare Inc | Community/Behavioral Health | 1 Jewel Dr, Wilmington, MA 01887-3385 | 2019-03-11 |
| 1457824369 | Ella Stanley Therapeutic Services, Inc. | Community/Behavioral Health | 1000 N West St Ste 1294, Wilmington, DE 19801-1050 | 2019-01-03 |
| 1134608136 | Alliance Behavioral Health | Community/Behavioral Health | 24505 S Avalon Blvd Apt 12, Wilmington, CA 90744-1068 | 2018-08-09 |
| 1063999688 | Tlc Operations, Inc | Community/Behavioral Health | 28 Beauregard Dr, Wilmington, NC 28412-6702 | 2018-07-26 |
| 1245752765 | Janelle G. Evans LLC | Community/Behavioral Health | 27 Tamarack Ave, Wilmington, DE 19805-5049 | 2017-07-17 |
| 1538698980 | Triad Ministry Inc | Community/Behavioral Health | 1104 N. Adams Street, Wilmington, DE 19801 | 2017-06-08 |
| 1356881551 | Jay's House, Inc | Community/Behavioral Health | 25 N Pennewell Dr, Wilmington, DE 19809-3313 | 2017-03-07 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
Please comment or provide details below to improve the information on COASTAL ENTERPRISES OF WILMINGTON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.