Healthcare Provider Details

I. General information

NPI: 1932957412
Provider Name (Legal Business Name): BAY HARBOR OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CIVIC AVE
SALISBURY MD
21804-4599
US

IV. Provider business mailing address

200 CIVIC AVE
SALISBURY MD
21804-4599
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-1466
  • Fax:
Mailing address:
  • Phone: 410-749-1466
  • 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: MINDEE POSEN
Title or Position: MEDICARE ADMINISTRATION OFFICER
Credential:
Phone: 845-825-2217