- Enrollment id
- O20150918000487
- Enrollment state
- NY
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1720460579
- Multiple npi flag
- N
- Ccn
- 335411
- Associate id
- 6800103169
- Organization name
- SEA CREST ACQUISITION I, LLC
- Doing business as name
- SEA CREST NURSING AND REHABILITATION CENTER
- Incorporation date
- 2013-01-17
- Incorporation state
- NY
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- SEA CREST NURSING AND REHABILITATION CENTER
- Affiliation entity name
- CASSENA CARE
- Affiliation entity id
- 119
- Address line 1
- 3035 W 24TH ST
- City
- BROOKLYN
- State
- NY
- Zip code
- 112242114