Seaside Healthcare LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2009 Issued in ME

Legal business name

SEASIDE HEALTHCARE LLC

Doing business as

Seaside Nursing & Retirement Home

Practice address

850 Baxter Blvd
Portland, ME 04103-4901

Phone

(207) 774-7878

NPI assigned

May 19, 2009

Organization subpart

No

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

Authorized official

Name

Wanda Pelkey

Title

Cfo

Phone

(207) 874-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Seaside Nursing & Retirement Home Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Seaside Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Seaside Healthcare LLC

  • Skilled Nursing Facility
  • Portland, ME
  • NPI 1902893555
  NPD tax ID

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1467687533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BAXTER BLVD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034901",
            "telephone_number": "207-774-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 BAXTER BLVD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034901",
            "telephone_number": "207-774-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "PELKEY",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "207-874-2700"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ME",
            "license": "2009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130930001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaside Nursing & Retirement Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anna C. Seadler, NP
• Mary Seaman
• Melissa Coffey Sears
• Stephen D Sears, MD
• Molly Elizabeth Searway
• Seaside Healthcare LLC
• Edward G Sebok, DMD
• Dave Seddon, MBA, RD, LD
• Maureen Sedgwick-Glidden, LMT
• Vonnett T Seeger, CRNA

• Assisted Living Facility in Portland, ME
• Providers in Portland, ME by specialty
• Assisted Living Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.