Organization
BAYSIDE CARE CENTER LP
Active
Other names
Bayside Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
KIM M BOULTON (CONTRACT COORDINATOR)
(847) 933-9200
Entity
Organization
Contact information
Practice address
1100 S LEWIS AVE, WAUKEGAN, IL 60085-7710
(847) 244-8196
Mailing address
5151 CHURCH ST, SKOKIE, IL 60077-1123
(847) 933-9200
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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