NPI 1710646641 · live from the CMS NPI Registry
Bayside Manor LLC
Skilled Nursing Facility in Gaylord, MN. National Provider Identifier 1710646641, active.
NPI record
| NPI | 1710646641 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 640 3rd St, Gaylord, MN 55334 |
| Practice phone | 507-237-2911 |
| Mailing address | 638 Southbend Ave, Mankato, MN 56001 |
| Enumerated | December 8, 2021 |
| Last updated | December 8, 2021 |
| Authorized official | Joshua Legum, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.