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Organization

COASTAL CARE ALLIANCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TELL D SACKETT (PRESIDENT & CEO)
(207) 432-6068
Entity
Organization

Contact information

Practice address
36 WADLEIGH ST APT A, PARSONSFIELD, ME 04047-6269
(207) 432-6068
Mailing address
36 WADLEIGH ST APT A, PARSONSFIELD, ME 04047-6269
(207) 432-6068

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
251C00000X
Developmentally Disabled Services Day Training Agency
251E00000X
Home Health Agency
Primary
253Z00000X
In Home Supportive Care Agency
261QA0600X
Adult Day Care Clinic/Center

Other

Enumeration date
02/10/2018
Last updated
02/18/2018
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