Provider Demographics
NPI:1013502251
Name:SEACOAST SNF LLC
Entity Type:Organization
Organization Name:SEACOAST SNF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DIFRANCESCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-501-9761
Mailing Address - Street 1:350 GRANITE ST STE 2203
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4963
Mailing Address - Country:US
Mailing Address - Phone:781-474-2263
Mailing Address - Fax:781-871-3986
Practice Address - Street 1:292 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-4832
Practice Address - Country:US
Practice Address - Phone:978-283-0300
Practice Address - Fax:978-281-6774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0946Medicaid