CCN: 239356 NPI: 1659015725 Organization

Bayside Wellness, LLC

236 1/2 E. FRONT ST. , SUITE 6
TRAVERSE CITY, MI 49684

Contact Information

Phone 2319466000
Fax 2319467000
Enumeration Date 2022-04-25
Last Updated 2024-02-29

Taxonomies

Code: 251E00000X (Primary)

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 3

cbsaActualGeographicLocation 23

providerType 36

censusDivision 3

cbsaActualGeographicLocation 23

providerType 36

censusDivision 3

cbsaActualGeographicLocation 23

providerType 36

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 23

providerType 36

specialPaymentIndicator

carrierCode 08202

localityCode 99

cbsaActualGeographicLocation 23

providerType 36

specialPaymentIndicator

carrierCode 08202

localityCode 99

cbsaActualGeographicLocation 23

providerType 36

specialPaymentIndicator

carrierCode 08202

localityCode 99