NPIMap

Organization Active NPI

Seacrest Village Adult Day Care

  • Adult Day Care Clinic/Center
  • Little Egg Harbor TWP, NJ
National Provider Identifier
1497176341
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
658333 Issued in NJ
Legal business name
SEACREST VILLAGE ADULT DAY CARE
Practice address
1001 Center St
Little Egg Harbor TWP, NJ 08087-1347
Phone
(609) 296-9292
Fax
(609) 296-0508
NPI assigned
Dec 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Authorized official

Name
Mrs. Michelle P Medora
Title
Business Office Manager
Phone
(609) 296-9292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 658333 NJ Primary

Addresses

Primary practice location

1001 Center St
Little Egg Harbor TWP, NJ 08087-1347

Mailing address

1001 Center St
Little Egg Harbor TWP, NJ 08087-1347
Phone (609) 296-9292

Other identifiers 1

IdentifierTypeStateIssuer
4494717MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1497176341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CENTER ST",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080871347",
            "telephone_number": "609-296-9292",
            "fax_number": "609-296-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 CENTER ST",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080871347",
            "telephone_number": "609-296-9292",
            "fax_number": "609-296-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACREST VILLAGE ADULT DAY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "MEDORA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "609-296-9292",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NJ",
            "license": "658333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4494717",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Egg Harbor TWP, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.