Healthcare Provider Details

I. General information

NPI: 1992231625
Provider Name (Legal Business Name): THE BAY AT NORTH RIDGE HEALTH AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 N 7TH ST
MANITOWOC WI
54220
US

IV. Provider business mailing address

1445 N 7TH ST
MANITOWOC WI
54220-2011
US

V. Phone/Fax

Practice location:
  • Phone: 920-682-0314
  • Fax:
Mailing address:
  • Phone: 920-682-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MENACHEM RUVEL
Title or Position: MANAGER
Credential:
Phone: 516-605-9800