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COASTAL SHORES
NPI 1710164611
Assisted Living Facility in Brunswick, ME

Active since January 23, 2008CLIA 20D2238771 · Waiver
142 NEPTUNE DRIVE, BRUNSWICK, ME 04011(207) 725-5801(207) 725-1404 Get Directions Write a Review

NPPES record last updated: October 7, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Coastal Shores NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL SHORES (NPI 1710164611) is a healthcare organization registered as an assisted living facility in Brunswick, Maine and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through October 5, 2027 and lists Mitchell A Rousseau, President, as its authorized official.

NPPES Registry Identity

NPI1710164611
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOASTAL SHORES, INC.
Location Address142 NEPTUNE DRIVEBrunswick, ME 04011
Mailing Address11 Bank StBrunswick, ME 04011-1501 · (207) 725-4071 · Fax (207) 725-4424
Phone(207) 725-5801
Fax(207) 725-1404
Organization SubpartNo
Authorized OfficialMitchell A RousseauPresident · (207) 725-4071
Enumeration DateJanuary 23, 2008
Last NPPES UpdateOctober 7, 2015
✔ NPI 1710164611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in ME · ALLS2967
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
142 NEPTUNE DRIVE, Brunswick, ME 04011
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Other Names 1

Doing Business AsCoastal Shores

Other Identifiers 1

Medicaid432796300ME

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D2238771

Coastal Shores · Brunswick, ME
Active · expires Oct 5, 2027
CLIA Number20D2238771
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 6, 2025
Certificate Expiration DateOctober 5, 2027
Laboratory DirectorDorothy Chubbuck
Laboratory Phone(207) 725-5801
Laboratory LocationCoastal Shores142 Neptune Drive, Brunswick, ME 04011
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coastal Shores, Inc.'s NPI number?

The NPI number for Coastal Shores, Inc. is 1710164611. It was assigned to this organization in the NPPES registry on January 23, 2008. The provider is doing business as Coastal Shores.

Where is Coastal Shores, Inc. located?

Coastal Shores, Inc. is located at 142 Neptune Drive, Brunswick, ME 04011. The listed phone number is (207) 725-5801.

What is Coastal Shores, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Coastal Shores, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2238771) is associated with this NPI, valid through October 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Coastal Shores, Inc. was last updated on October 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.