Provider Demographics
NPI:1134410533
Name:BAY CITY HEALTH AND REHABILITATION CENTER, LLC
Entity type:Organization
Organization Name:BAY CITY HEALTH AND REHABILITATION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:Z
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:979-245-1414
Mailing Address - Street 1:1221 AVENUE F
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3413
Mailing Address - Country:US
Mailing Address - Phone:979-245-1414
Mailing Address - Fax:979-245-1555
Practice Address - Street 1:1221 AVENUE F
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3413
Practice Address - Country:US
Practice Address - Phone:979-245-1414
Practice Address - Fax:979-245-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB130117Medicare PIN