MEDICARE: SEABROOK VILLAGE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1144272311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEABROOK VILLAGE, INC

Provider Business Mailing Address
First Line	:	3000 ESSEX ROAD
Second Line	:	ATTN: EXECUTIVE DIRECTOR
City	:	TINTON FALLS
State	:	NJ
Zip	:	07753-2631
Country	:	US
Telephone Number	:	732-643-1200
Fax Number	:	410-204-7237

Provider Business Practice Location Address
First Line	:	3004 ESSEX ROAD
Second Line	:	ATTN: REHABILITATION MANAGER
City	:	TINTON FALLS
State	:	NJ
Zip	:	07753-0000
Country	:	US
Telephone Number	:	732-643-1200
Fax Number	:	410-204-7237

Authorized Official
Title or Position	:	ASSISTANT TREASURER
Name	:	CHRISTOPHER J RATHMANN
Credential	:
Telephone Number	:	410-402-2390

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	10/11/2012

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