Provider Demographics
NPI:1386049880
Name:AM SEASIDE RETIREMENT RESORT
Entity type:Organization
Organization Name:AM SEASIDE RETIREMENT RESORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-457-0100
Mailing Address - Street 1:2091 S OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-6645
Mailing Address - Country:US
Mailing Address - Phone:954-457-0100
Mailing Address - Fax:954-455-4514
Practice Address - Street 1:2091 S OCEAN DR
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-6645
Practice Address - Country:US
Practice Address - Phone:954-457-0100
Practice Address - Fax:954-455-4514
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AM SEASIDE RETIREMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL7722310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility