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General NPI Number Information
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NPI Number | 1730176561
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Entity Type | Organization
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Legal Business Name | SEASHORE POINT-DEACONESS, INC.
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 100 ALDEN ST
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City | PROVINCETOWN
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State | MA
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Zip | 02657
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Country | US
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Telephone | 508-487-7090
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Fax | 508-487-2967
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Provider Business Mailing Address
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Address Line | 80 DEACONESS ROAD
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City | CONCORD
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State | MA
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Zip | 01742
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Country | US
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Telephone | 978-369-5151
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Fax | 978-371-1755
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | HERB TAYLOR
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Credential |
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Telephone | 978-369-5151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0849
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License Number State | MA
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