20D0088664 CLIA NUMBER - SEASIDE NURSING HOME ATTN LISA ROGERS RN DNS

Laboratory Demographics

CLIA Number: 20D0088664

Facility Name: SEASIDE NURSING HOME ATTN LISA ROGERS RN DNS

Facility Address:
850 BAXTER BLVD
PORTLAND, ME
ZIP 04103
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Facility Phone Number: 207 774-7878

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1467687533

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	20D0088664
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	SEASIDE NURSING HOME ATTN LISA ROGERS RN DNS
Street	850 BAXTER BLVD
City	PORTLAND
State	ME
ZIP	04103
Phone	207 774-7878
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024