Seacoast at Governor'S Glen

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SEACOAST AT GOVERNOR'S GLEN

Practice address

5000 Governors Dr
Forest Park, GA 30297-6138

Phone

(404) 362-0404

NPI assigned

Mar 4, 2026

Organization subpart

No

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

Authorized official

Name

Stephen Nadeau

Title

Chief Operating Officer

Phone

(954) 261-2650

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1487509485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 GOVERNORS DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976138",
            "telephone_number": "404-362-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 GOVERNORS DR",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976138",
            "telephone_number": "404-362-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACOAST AT GOVERNOR'S GLEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "NADEAU",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "954-261-2650"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Forest Park, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.