Seaside Manor Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

8860 Issued in FL

Legal business name

SEASIDE MANOR ALF LLC

Practice address

1050 Ocean Shore Blvd
Ormond Beach, FL 32176-4126

Phone

(386) 441-1771

NPI assigned

Aug 28, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Zevi Kohn

Title

Member

Phone

(718) 338-2999

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1235656455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 OCEAN SHORE BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321764126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 OCEAN SHORE BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321764126",
            "telephone_number": "386-441-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE MANOR ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-28",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "KOHN",
        "authorized_official_first_name": "ZEVI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-338-2999"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "8860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALF",
            "identifier": "8860",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.