| Organization Name: | SEACREST VILLAGE ADULT DAY CARE |
| NPI Number: | 1497176341 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHELLE P MEDORA (BUSINESS OFFICE MANAGER) |
| Mailing Address: | 1001 Center St Little Egg Harbor Twp |
| State: | NJ US |
| Postal Code: | 080871347 |
| Phone Number: | 6092969292 |
| Fax Number: | 6092960508 |
| NPI Enumeration Date: | 12/19/2013 |
| NPI Last Update Date: | 12/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | 658333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |