Provider Demographics
NPI:1639250913
Name:BAY CLIFF HEALTH CAMP
Entity Type:Organization
Organization Name:BAY CLIFF HEALTH CAMP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-345-9314
Mailing Address - Street 1:N4175 CO RD KCA
Mailing Address - Street 2:PO BOX 310
Mailing Address - City:BIG BAY
Mailing Address - State:MI
Mailing Address - Zip Code:49808
Mailing Address - Country:US
Mailing Address - Phone:906-345-9314
Mailing Address - Fax:906-345-9890
Practice Address - Street 1:N4175 CO RD KCA
Practice Address - Street 2:
Practice Address - City:BIG BAY
Practice Address - State:MI
Practice Address - Zip Code:49808
Practice Address - Country:US
Practice Address - Phone:906-345-9314
Practice Address - Fax:906-345-9890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable