# SEASIDE VILLA ASSISTED LIVING FACILITY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609625284
- **Authorized official:** GAIL RANEA MACKEY LCSW (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (321) 626-5321

## Contact information

- **Practice address:** 610 PALM DRIVE, SATELLITE BEACH, FL 32937
- **Practice address phone:** (321) 626-5321
- **Practice address fax:** (321) 777-7545
- **Mailing address:** 610 PALM DRIVE, SATELLITE BEACH, FL 32937
- **Mailing address phone:** (321) 626-5321
- **Mailing address fax:** (321) 777-7545

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2024
- **Last updated:** 05/15/2024