MEDICARE: BAYBREEZE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	323P00000X	Psychiatric Residential Treatment Facility	191600093	CA

General Provider Information

NPI Number	:	1578739637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYBREEZE

Provider Business Mailing Address
First Line	:	1653 SANTA FE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1240
Country	:	US
Telephone Number	:	562-432-8033
Fax Number	:

Provider Business Practice Location Address
First Line	:	1653 SANTA FE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1240
Country	:	US
Telephone Number	:	562-432-8033
Fax Number	:

Authorized Official
Title or Position	:	ADULT CARETAKER
Name	:	MRS. TESS BOLONG
Credential	:	AD
Telephone Number	:	562-432-8033

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	05/07/2008

Similar Medicare Providers

1679105746 — DR. ELIDGE DEMETE ANDERSON DC
Practice Location Address:

272 E 69TH WAY
LONG BEACH, CA
90805-1240

Practice Phone: 757-282-8111
Practice Fax:

1114532447 — MELISSA SUE COBB DPT
Practice Location Address:

1240 W GRANADA BLVD STE 1
ORMOND BEACH, FL
32174-6020

Practice Phone: 386-898-0220
Practice Fax:

1073519864 — FLAGLER CHIROPRACTIC PA
Practice Location Address:

1240 SOUTH AIA
FLAGLER BEACH, FL
32136

Practice Phone: 386-439-9001
Practice Fax: 386-439-9002

1932195385 — JOHN BLAKE HOLT M.D.
Practice Location Address:

1240 W GRANADA BLVD FL 2
ORMOND BEACH, FL
32174-5915

Practice Phone: 386-672-9503
Practice Fax: 386-672-0386

1548219058 — DR. KENNETH PETER ORBECK D.O.
Practice Location Address:

1240 21ST AVE N , SUITE 105
MYRTLE BEACH, SC
29577-7401

Practice Phone: 843-839-0270
Practice Fax: 843-839-0276

1821027962 — TOTAL CARE HOME HEALTH OF SOUTH CAROLINA, LLC
Practice Location Address:

1240 21ST AVE N , SUITE 200
MYRTLE BEACH, SC
29577-7401

Practice Phone: 843-448-7060
Practice Fax:

Directions to “BAYBREEZE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.