Healthcare Provider Details

I. General information

NPI: 1093587065
Provider Name (Legal Business Name): BAY TERRACE REHABILITATION AND HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

889 S LITTLE CREEK RD
DOVER DE
19901-4721
US

IV. Provider business mailing address

889 S LITTLE CREEK RD
DOVER DE
19901-4721
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-0566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MOSHE STERN
Title or Position: AUTHORIZED MEMBER
Credential:
Phone: 302-674-0566