Bayside Terrace LLC
NPI #1912029521 in Waukegan, Illinois
Provider Information
- NPI Number
- 1912029521
- Entity Type
- Organization
- Organization Name
- Bayside Terrace LLC
- Primary Specialty
- Intermediate Care Facility, Mental Illness
- Enumeration Date
- Apr 4, 2007
- Last Updated
- Jul 20, 2016
Practice Location
Authorized Official
- Name
- DEMETRIA C. RAFAEL, RN
- Title
- ADMINISTRATOR
- Phone
- (847) 244-8196
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Mental Illness |
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