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Organization
COASTAL SHORES, INC.
Active
Organization
COASTAL SHORES, INC.
Active
Other names
Coastal Shores
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL A ROUSSEAU (PRESIDENT)
(207) 725-4071
Entity
Organization
Contact information
Practice address
142 NEPTUNE DRIVE, BRUNSWICK, ME 04011
(207) 725-5801
(207) 725-1404
Mailing address
11 BANK ST, BRUNSWICK, ME 04011-1501
(207) 725-4071
(207) 725-4424
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALLS2967
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432796300
—
ME
Enumeration date
01/23/2008
Last updated
10/07/2015
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