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Contact Information

COASTAL SOUTHEASTERN UNITED CARE LLC
10 DOCTORS CIRCLE
SUITE 6
SUPPLY, NC28462
 Phone: 910-755-5222
 Fax: 910-755-5255
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
 

Case Management

251B00000X
 

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
 

Mental Health

101YM0800X
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for COASTAL SOUTHEASTERN UNITED CARE LLC

NPI Number 1346477403
LBN Legal business name COASTAL SOUTHEASTERN UNITED CARE LLC
Authorized official SHANNON ATKINSON - (VP, HOME AND COMMUNITY SERVICES)
Entity Organization
Organization subpart 1 No
Enumeration date 06/16/2009
Last updated 09/02/2025 - About 9 months ago
Identifiers
NC Medicaid 8302940
NC Medicaid 8302940B
NC Medicaid 8302940G
NC Medicaid 8302940H
NC Other B913 MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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