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Contact Information

SEASIDE HEALTHCARE LLC
850 BAXTER BLVD
PORTLAND, ME04103-4901
 Phone: 207-774-7878
 Fax: 207-775-2811
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Occupational Medicine

261QX0100X
 

Physical Therapy

261QP2000X
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for SEASIDE HEALTHCARE LLC

NPI # 1902893555
LBN Legal business name SEASIDE HEALTHCARE LLC
Authorized official KENNETH BOWDEN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/29/2005
Last updated 05/20/2009 - About 17 years ago
Identifiers
ME License # 1902
ME License # 36297
ME Medicaid 130930000
ME Medicaid 13093001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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