Provider Demographics
NPI:1356151161
Name:SOUTHCOAST LONG-TERM CARE SERVICES, INC.
Entity type:Organization
Organization Name:SOUTHCOAST LONG-TERM CARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUSHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-973-5017
Mailing Address - Street 1:389 ALDEN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4451
Mailing Address - Country:US
Mailing Address - Phone:508-973-2953
Mailing Address - Fax:
Practice Address - Street 1:389 ALDEN RD
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-4451
Practice Address - Country:US
Practice Address - Phone:508-991-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251J00000XAgenciesNursing Care