Provider Demographics
NPI:1598300089
Name:BAYSIDE SENIOR CARE, L.L.C.
Entity Type:Organization
Organization Name:BAYSIDE SENIOR CARE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-393-1515
Mailing Address - Street 1:3201 WALL BLVD
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7875
Mailing Address - Country:US
Mailing Address - Phone:504-393-1515
Mailing Address - Fax:504-391-7426
Practice Address - Street 1:3201 WALL BLVD
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7875
Practice Address - Country:US
Practice Address - Phone:504-393-1515
Practice Address - Fax:504-391-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility