Provider Demographics
NPI:1053313825
Name:BAIRD NURSING HOME,LLC
Entity Type:Organization
Organization Name:BAIRD NURSING HOME,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:HEARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-342-5540
Mailing Address - Street 1:2150 SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-1415
Mailing Address - Country:US
Mailing Address - Phone:585-342-5540
Mailing Address - Fax:585-342-3539
Practice Address - Street 1:2150 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1415
Practice Address - Country:US
Practice Address - Phone:585-342-5540
Practice Address - Fax:585-342-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2701357N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02130963Medicaid
NY125008CIOtherPREFERRED CARE
NYP015005978OtherEXCELLUS BLUE CROSS
NY335825Medicare Oscar/Certification