Provider Demographics
NPI:1689893638
Name:BAY PINES HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:BAY PINES HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED THERAPEUTIC RECREATION SP
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:WREN
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS / CTRS
Authorized Official - Phone:727-398-6661
Mailing Address - Street 1:P.O BOX 5005
Mailing Address - Street 2:
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33744
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:727-398-9465
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-398-9465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty