Colonial Rest Home Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

094010 Issued in MI

Legal business name

COLONIAL REST HOME INC

Doing business as

The Carriage House of Bay City

Practice address

2394 Midland Rd
Bay City, MI 48706-9402

Phone

(989) 684-2303

Fax

(989) 684-2849

NPI assigned

Aug 9, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Raphael Dubay

Title

Owner Administrator

Phone

(989) 684-2303

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Carriage House of Bay City Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003817321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2394 MIDLAND RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069402",
            "telephone_number": "989-684-2303",
            "fax_number": "989-684-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2394 MIDLAND RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069402",
            "telephone_number": "989-684-2303",
            "fax_number": "989-684-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL REST HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUBAY",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "989-684-2303",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "094010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2080190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Carriage House of Bay City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Bay City, MI
• Providers in Bay City, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.