Healthcare Provider Details

I. General information

NPI: 1831186451
Provider Name (Legal Business Name): SEA CREST HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 W 24TH ST
BROOKLYN NY
11224-2114
US

IV. Provider business mailing address

3035 W 24TH ST
BROOKLYN NY
11224-2114
US

V. Phone/Fax

Practice location:
  • Phone: 718-372-4500
  • Fax: 718-372-4579
Mailing address:
  • Phone: 718-372-4500
  • Fax: 718-372-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number7001345N
License Number StateNY

VIII. Authorized Official

Name: MS. EVELYN JONES
Title or Position: ADMINISTRATOR
Credential: NHLA
Phone: 718-372-4500