Organization
SEASIDE HEALTHCARE LLC
Active
Other names
Seaside Retirement and Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH BOWDEN (CEO)
(207) 874-2700
Entity
Organization
Contact information
Practice address
850 BAXTER BLVD, PORTLAND, ME 04103-4901
(207) 774-7878
(207) 775-2811
Mailing address
850 BAXTER BLVD, PORTLAND, ME 04103-4901
(207) 774-7878
(207) 775-2811
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
36297
ME
261QP2000X
Physical Therapy Clinic/Center
36297
ME
261QX0100X
Occupational Medicine Clinic/Center
36297
ME
314000000X
Skilled Nursing Facility
Primary
1902
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130930000
—
ME
05
—
13093001
—
ME
Enumeration date
09/29/2005
Last updated
05/20/2009
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