- Enrollment id
- O20130304000413
- Enrollment state
- CA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1386998664
- Multiple npi flag
- N
- Ccn
- 056348
- Associate id
- 5890940514
- Organization name
- BAY VIEW REHABILITATION HOSPITAL LLC
- Doing business as name
- BAY VIEW REHABILITATION HOSPITAL LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BAY VIEW REHABILITATION HOSPITAL, LLC
- Affiliation entity name
- DAVID JOHNSON
- Affiliation entity id
- 851
- Address line 1
- 516 WILLOW ST
- City
- ALAMEDA
- State
- CA
- Zip code
- 945016132