Seaside Manor, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL8860 Issued in FL

Legal business name

SEASIDE MANOR, LLC

Practice address

1050 Ocean Shore Blvd
Ormond Beach, FL 32176-4126

Phone

(386) 441-1771

NPI assigned

Oct 16, 2012

Last updated

May 23, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

SABER HEALTHCARE HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

William I. Weisberg

Title

Vice President

Phone

(216) 292-5706

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369267200000",
    "number": "1790038776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26691 RICHMOND RD",
            "city": "BEDFORD HEIGHTS",
            "state": "OH",
            "postal_code": "441461421",
            "telephone_number": "216-292-5706",
            "fax_number": "216-292-2273"
        },
        {
            "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, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SABER HEALTHCARE HOLDINGS, LLC",
        "enumeration_date": "2012-10-16",
        "last_updated": "2013-05-23",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "216-292-5706"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL8860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008052000",
            "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 May 23, 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.