Healthcare Provider Details

I. General information

NPI: 1891845210
Provider Name (Legal Business Name): BAY SHORES NURSING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3254 E MIDLAND RD
BAY CITY MI
48706-2835
US

IV. Provider business mailing address

10503 CITATION DR STE 100
BRIGHTON MI
48116-6551
US

V. Phone/Fax

Practice location:
  • Phone: 989-686-3770
  • Fax: 989-686-3414
Mailing address:
  • Phone: 810-534-0150
  • Fax: 810-534-0208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number094050
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number094050
License Number StateMI

VIII. Authorized Official

Name: TODD SANGSTER
Title or Position: CFO
Credential:
Phone: 810-534-0150