Organization
SEACREST RESIDENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARLENE HENRY (MANAGER)
(561) 577-3589
Entity
Organization
Contact information
Practice address
144 SE 31ST AVE, BOYNTON BEACH, FL 33435-8227
(561) 577-3589
Mailing address
144 SE 31ST AVE, BOYNTON BEACH, FL 33435-8227
(561) 577-3589
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
091916
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014795000
—
FL
Enumeration date
11/22/2015
Last updated
11/22/2015
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