Organization · NPI-2
Coastal Shores, INC.
Assisted Living Facility · Brunswick, ME
NPI number1710164611
StatusActive
Last updated in NPPESOct 7, 2015
Details
- NPI
- 1710164611
- Entity type
- Organization (NPI-2)
- Legal business name
- Coastal Shores, INC.
- Organization subpart
- No
- Enumeration date
- Jan 23, 2008
- Last updated
- Oct 7, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | ALLS2967 | ME | Yes |
Other names
- Coastal Shores (Doing Business As)
Practice location
142 Neptune DriveBrunswick, ME 04011
Phone 207-725-5801 · Fax 207-725-1404
Mailing address
11 Bank StBrunswick, ME 04011-1501
Phone 207-725-4071 · Fax 207-725-4424
Authorized official
Mitchell A Rousseau
President
2077254071
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