Organization
COASTLINE ELDERLY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES N. SISSON (EXECTUTIVE DIRECTOR)
(508) 742-9127
Entity
Organization
Contact information
Practice address
1646 PURCHASE ST, NEW BEDFORD, MA 02740-6819
(508) 999-6400
(508) 993-6510
Mailing address
1646 PURCHASE ST, NEW BEDFORD, MA 02740-6819
(508) 999-6400
(508) 993-6510
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0603651
PROVIDER NUMBER
MA
Enumeration date
04/18/2007
Last updated
08/22/2020
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