Provider Demographics
NPI:1467485235
Name:BAYPOINTE NURSING HOME INC
Entity Type:Organization
Organization Name:BAYPOINTE NURSING HOME INC
Other - Org Name:BAYPOINTE REHABILITATION & SKILLED CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED ADMINISTRAT
Authorized Official - Phone:508-580-6800
Mailing Address - Street 1:50 CHRISTY PLACE
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301
Mailing Address - Country:US
Mailing Address - Phone:508-580-6800
Mailing Address - Fax:508-587-6633
Practice Address - Street 1:50 CHRISTY PLACE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-580-6800
Practice Address - Fax:508-587-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0E4B314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0922579Medicaid
MA0922579Medicaid