Provider Demographics
NPI:1700880630
Name:BAY CENTER REHABILITATION, LLC
Entity Type:Organization
Organization Name:BAY CENTER REHABILITATION, LLC
Other - Org Name:SWEET BAY HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-346-6454
Mailing Address - Street 1:1665 PALM BEACH LAKES BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2108
Mailing Address - Country:US
Mailing Address - Phone:561-801-7600
Mailing Address - Fax:
Practice Address - Street 1:1336 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-2762
Practice Address - Country:US
Practice Address - Phone:863-533-0578
Practice Address - Fax:863-533-0736
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTHSTONE SENIOR COMMUNITIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-09
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF10340961314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021298900Medicaid
FL021298900Medicaid