Sea Breeze Wellness Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

E0230732015-6 Issued in NV

Legal business name

SEA BREEZE WELLNESS CENTER

Doing business as

Sea Breeze Therapy Center

Practice address

2021 S Jones Blvd Ste C
Las Vegas, NV 89146-3137

Phone

(702) 476-0909

Fax

(702) 476-0983

NPI assigned

Dec 15, 2016

Organization subpart

No

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

Authorized official

Name

Michelle King

Title

Director

Phone

(702) 476-0909

Specialties & licenses 1

Addresses

Other names 1

• Sea Breeze Therapy Center Doing business as

Tax ID family

Sea Breeze Therapy Center2 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.

• Sea Breeze Wellness Center LTD

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Las Vegas, NV
  • NPI 1366820961
  NPD tax ID

Locations

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1841734415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 S JONES BLVD STE C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463137",
            "telephone_number": "702-476-0909",
            "fax_number": "702-476-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 S JONES BLVD STE C",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463137",
            "telephone_number": "702-476-0909",
            "fax_number": "702-476-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA BREEZE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-476-0909"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "E0230732015-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea Breeze Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter Aylward Scully, MD
• Sculpted Beauty LV LLC (Artisan Aesthetics and Bodywork)
• Sdee LLC
• Sdmi, LLC (Steinberg Diagnostic Medical Imaging)
• SE Medical Supply
• Sea Breeze Wellness Center LTD
• Sea Side Transit LLC (Vegas Light Care PCA LLC)
• Tommie Lee Sea Jr.
• Tekakwitha Seaboy
• Seabreeze Holistic Care LLC

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.