Organization
MID COAST GERIATRIC SERVICES CORP
Active
Other names
Mid Coast Senior Health
Organization subpart
No
Provider details
NPI number
Authorized official
KIM WATSON (ADMINISTRATOR)
(207) 373-3630
Entity
Organization
Contact information
Practice address
58 BARIBEAU DR, BRUNSWICK, ME 04011-3218
(207) 373-3638
(207) 373-3640
Mailing address
58 BARIBEAU DR, BRUNSWICK, ME 04011-3218
(207) 373-3638
(207) 373-3640
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1952
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128310000
—
ME
01
—
NG0093
MEDICARE B
ME
Enumeration date
11/07/2005
Last updated
01/30/2023
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