Organization
COASTAL REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATHALIE DESCHENEAUX OTR/L (OWNER)
(207) 767-9773
Entity
Organization
Contact information
Practice address
2 DAVIS POINT LANE, SUITE 1A, CAPE ELIZABETH, ME 04107
(207) 767-9773
Mailing address
2 DAVIS POINT LN, SUITE 1A, CAPE ELIZABETH, ME 04107-2620
(207) 767-9773
(207) 541-9212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1728
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431781700
—
ME
Enumeration date
04/11/2006
Last updated
03/09/2012
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