Provider Demographics
NPI:1043489016
Name:BAYWOOD COURT
Entity type:Organization
Organization Name:BAYWOOD COURT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-733-2401
Mailing Address - Street 1:21966 DOLORES ST
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-6959
Mailing Address - Country:US
Mailing Address - Phone:510-733-2102
Mailing Address - Fax:510-733-2480
Practice Address - Street 1:21966 DOLORES ST
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-6959
Practice Address - Country:US
Practice Address - Phone:510-733-2102
Practice Address - Fax:510-733-2480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000793314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550000793Medicaid
CA555855Medicare Oscar/Certification
555855Medicare Oscar/Certification