Provider Demographics
NPI:1942954060
Name:THE BAY AT DYERSBURG HEALTH AND REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:THE BAY AT DYERSBURG HEALTH AND REHABILITATION CENTER LLC
Other - Org Name:DYERSBURG HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MENACHEM
Authorized Official - Middle Name:
Authorized Official - Last Name:RUVEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-605-9800
Mailing Address - Street 1:350 E TICKLE ST
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-3118
Mailing Address - Country:US
Mailing Address - Phone:731-285-9710
Mailing Address - Fax:731-285-9949
Practice Address - Street 1:350 E TICKLE ST
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3118
Practice Address - Country:US
Practice Address - Phone:731-285-9710
Practice Address - Fax:731-285-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility