Provider Demographics
NPI:1720896459
Name:SEASHORE CAMPGROUNDS RETIREMENT HOME INC.
Entity type:Organization
Organization Name:SEASHORE CAMPGROUNDS RETIREMENT HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE AND CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUELZKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-432-2915
Mailing Address - Street 1:PO BOX 1567
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38802-1567
Mailing Address - Country:US
Mailing Address - Phone:662-844-8977
Mailing Address - Fax:662-690-6643
Practice Address - Street 1:12170 HIGHLAND WAY
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3666
Practice Address - Country:US
Practice Address - Phone:228-831-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MISSISSIPPI METHODIST SENIOR SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility