| Organization Name: | SEASHORE POINT - DEACONESS INC |
| NPI Number: | 1114160553 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN COLARUSSO (ADMINISTRATOR) |
| Mailing Address: | 100 Alden St Provincetown |
| State: | MA US |
| Postal Code: | 026571456 |
| Phone Number: | 5084877090 |
| Fax Number: | 5084877706 |
| NPI Enumeration Date: | 04/15/2009 |
| NPI Last Update Date: | 04/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | 0849 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |