Provider Demographics
NPI:1629796149
Name:BAYVIEW RECOVERY CENTER LLC
Entity Type:Organization
Organization Name:BAYVIEW RECOVERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-342-9151
Mailing Address - Street 1:2380 TERRAZA PANGA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-6616
Mailing Address - Country:US
Mailing Address - Phone:858-342-9151
Mailing Address - Fax:
Practice Address - Street 1:2380 TERRAZA PANGA
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-6616
Practice Address - Country:US
Practice Address - Phone:858-342-9151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder