Organization
BARAGA COUNTY EXTENDED CARE CORPORATION
Active
Other names
Dr. Louis & Anne Guy Bayside Village
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY A DAULT RN, LNHA (ADMINISTRATOR)
(906) 524-6531
Entity
Organization
Contact information
Practice address
832 SICOTTE ST, LANSE, MI 49946-1243
(906) 524-6531
(906) 524-7533
Mailing address
832 SICOTTE ST, LANSE, MI 49946-1243
(906) 524-6531
(906) 524-7533
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
074010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09543
BLUE CROSS
MI
05
—
3215447
—
MI
Enumeration date
08/30/2006
Last updated
05/08/2026
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