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Organization
SEACREST VILLAGE, INC
Active
Organization
SEACREST VILLAGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN T. HOLLOWAY (PRESIDENT)
(609) 296-9292
Entity
Organization
Contact information
Practice address
1001 CENTER ST, LITTLE EGG HARBOR TWP, NJ 08087-1347
(609) 296-9292
(609) 296-0508
Mailing address
1001 CENTER ST, PO BOX 1480, LITTLE EGG HARBOR TWP, NJ 08087-1347
(609) 296-9292
(609) 296-0508
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NJ61522
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077801
—
NJ
05
—
4494709
—
NJ
05
—
4494717
—
NJ
Enumeration date
09/30/2005
Last updated
08/22/2020
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