Sea Breeze Retreat Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SEA BREEZE RETREAT INC.

Practice address

3132 Robinson Ave
Scottdale, GA 30079-1526

Phone

(678) 409-8361

NPI assigned

Aug 15, 2012

Organization subpart

No

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

Authorized official

Name

Miss Nicole Thebaud, MS NICOLE THEBAUD

Title

Director

Phone

(678) 409-8361

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1982952438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 ROBINSON AVE",
            "city": "SCOTTDALE",
            "state": "GA",
            "postal_code": "300791526",
            "telephone_number": "678-409-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 ROBINSON AVE",
            "city": "SCOTTDALE",
            "state": "GA",
            "postal_code": "300791526",
            "telephone_number": "678-409-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA BREEZE RETREAT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "THEBAUD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "678-409-8361",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MS NICOLE THEBAUD"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plural Psychotherapy
• Praada Academy Schools
• R Neil Johnston MD LLC
• Shahzeen Rehman, FNP-C
• Gretha Rojas Ulloa
• Jaime Candace Singletary, OTRL
• Barrett Smith
• Marissa Speed
• Elle Udaykee Trapkin, LCSW
• Alisha Uppal, LPC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Scottdale, GA
• Providers in Scottdale, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.