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34D2115326 CLIA NUMBER - COASTAL RESIDENTIAL SERVICES, INC GREENBRIAR - J

Laboratory Demographics

CLIA Number: 34D2115326

Facility Name: COASTAL RESIDENTIAL SERVICES, INC GREENBRIAR - J

Facility Address:
211 GREENBRIAR DRIVE
JACKSONVILLE, NC
ZIP 28546
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Facility Phone Number: 910 938-9550

Facility Type: Other - GROUP HOME

Certificate Type: Waiver
NPI Number: 1780792705

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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.

CLIA Record

Field Name Field Value
CLIA Number 34D2115326
LAB Type Other - GROUP HOME
Facility Name COASTAL RESIDENTIAL SERVICES, INC GREENBRIAR - J
Street 211 GREENBRIAR DRIVE
City JACKSONVILLE
State NC
ZIP 28546
Phone 910 938-9550
CertificateType 4
CertificateEffectiveDate 7/5/2022
CertificateExpirationDate 7/4/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024