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COASTAL HAVEN HOME
NPI 1164647277
Community Based Residential Treatment Facility, Mental Illness in Supply, NC

Active since April 16, 2007
399 DOE RUN DR., SUPPLY, NC 28462(910) 846-9196 Get Directions Write a Review

NPPES record last updated: June 27, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Coastal Haven Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL HAVEN HOME (NPI 1164647277) is a healthcare organization registered as a community based residential treatment facility, mental illness in Supply, North Carolina and active in the NPI registry since April 2007. The organization lists Wanda Denise Wilson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1164647277
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameCOASTAL HAVEN HOME
Location Address399 DOE RUN DR.Supply, NC 28462-6349
Mailing Address1290 Windy Ridge Trl Sw, P.o.ox 721Supply, NC 28462-3215 · (910) 846-9196
Phone(910) 846-9196
Organization SubpartNo
Authorized OfficialWanda Denise WilsonAdministrator · (910) 846-9196
Enumeration DateApril 16, 2007
Last NPPES UpdateJune 27, 2008
✔ NPI 1164647277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
399 DOE RUN DR., Supply, NC 28462
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coastal Haven Home's NPI number?

The NPI number for Coastal Haven Home is 1164647277. It was assigned to this organization in the NPPES registry on April 16, 2007.

Where is Coastal Haven Home located?

Coastal Haven Home is located at 399 Doe Run Dr., Supply, NC 28462. The listed phone number is (910) 846-9196.

What is Coastal Haven Home's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Coastal Haven Home was last updated on June 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.