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General NPI Number Information
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NPI Number | 1902983240
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Entity Type | Organization
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Legal Business Name | SEACOAST NURSING AND REHABILITATION CENTER, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/13/2015
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Provider Practice Location Address
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Address Line | 292 WASHINGTON ST
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City | GLOUCESTER
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State | MA
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Zip | 01930-4832
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Country | US
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Telephone | 978-283-0300
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Fax | 978-281-6774
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Provider Business Mailing Address
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Address Line | 292 WASHINGTON ST
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City | GLOUCESTER
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State | MA
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Zip | 01930-4832
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Country | US
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Telephone | 978-283-0300
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Fax | 978-281-6774
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | MS. MARILYN WEAVER
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Credential |
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Telephone | 502-596-7563
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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 | 0946
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License Number State | MA
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