Provider Demographics
NPI:1407591274
Name:BAY AT MUSKEGO HEALTH AND REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:BAY AT MUSKEGO HEALTH AND REHABILITATION CENTER LLC
Other - Org Name:MUSKEGO HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MENACHEM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUVEL
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:516-605-9800
Mailing Address - Street 1:165 N VILLAGE AVE STE 126
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3763
Mailing Address - Country:US
Mailing Address - Phone:516-605-9800
Mailing Address - Fax:516-766-1039
Practice Address - Street 1:S77W18690 JANESVILLE RD
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-9207
Practice Address - Country:US
Practice Address - Phone:262-679-0246
Practice Address - Fax:262-679-9717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility