Organization
ECUMEN
Active
Other names
dba Bayshore Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHRYN R ROBERTS (CEO,PRESIDENT)
(651) 766-4313
Entity
Organization
Contact information
Practice address
1601 SAINT LOUIS AVE, DULUTH, MN 55802-2442
(218) 727-8651
Mailing address
1601 SAINT LOUIS AVE, DULUTH, MN 55802-2442
(218) 727-8651
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
332717
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183488600
—
MN
01
—
411768508
ST MARY HOSPICE
MN
01
—
5G48BA
BCBS
MN
01
—
7122550
MEDICA
MN
01
—
90160
VA
MN
01
—
NH0506
UCARE
MN
Enumeration date
02/05/2007
Last updated
03/17/2010
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