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Coastal Residential Services, Inc

Community/Behavioral Health Agency in Jacksonville, NC · enumerated 2006 · authorized official Carol Wilson, Vice President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1780792705

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Registry record

Entity type Organization (Type 2)
Legal business name Coastal Residential Services, Inc
Practice address 445 Western Blvd Ste T, Jacksonville, NC, 28546
Phone (910) 938-9550
Fax (910) 346-9186
Enumeration date Aug 29, 2006
Last updated in NPPES Nov 18, 2020

Taxonomy & classification

251S00000X Community/Behavioral Health Agency Agencies · License MHL-067-085 (NC) Primary
251S00000X Community/Behavioral Health Agency Agencies · License MHL-067-052 (NC) Secondary
251S00000X Community/Behavioral Health Agency Agencies · License MHL-067-049 (NC) Secondary
251S00000X Community/Behavioral Health Agency Agencies · License MHL-067-059 (NC) Secondary
251S00000X Community/Behavioral Health Agency Agencies · License MHL-067-091 (NC) Secondary
320900000X Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Residential Treatment Facilities · License MHL-067-052 (NC) Secondary
320900000X Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Residential Treatment Facilities · License MHL-067049 (NC) Secondary
320900000X Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Residential Treatment Facilities · License MHL-067-059 (NC) Secondary
320900000X Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Residential Treatment Facilities · License MHL-067-091 (NC) Secondary

Authorized official

Name Carol Wilson
Title Vice President
Phone (910) 938-9550

Other identifiers

Identifier Type State Issuer
3419231 Medicaid NC -
3408942 Medicaid NC -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Coastal Residential Services, Inc?
NPPES lists Carol Wilson (Vice President) as the authorized official for this organization.
What is the NPI number for Coastal Residential Services, Inc?
The NPI for Coastal Residential Services, Inc is 1780792705, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-11-18.