Provider Demographics
NPI:1184271140
Name:SEASIDE HOME HEALTH LLC
Entity type:Organization
Organization Name:SEASIDE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-437-1411
Mailing Address - Street 1:3212 GULFSTREAM RD
Mailing Address - Street 2:
Mailing Address - City:GULF STREAM
Mailing Address - State:FL
Mailing Address - Zip Code:33483-7314
Mailing Address - Country:US
Mailing Address - Phone:561-437-1411
Mailing Address - Fax:831-851-1876
Practice Address - Street 1:10 FAIRWAY DR STE 111
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1827
Practice Address - Country:US
Practice Address - Phone:561-437-1411
Practice Address - Fax:831-851-1876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health