The Bay at Colonial Manor Health and Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE BAY AT COLONIAL MANOR HEALTH AND REHABILITATION LLC

Practice address

1010 E Wausau Ave
Wausau, WI 54403

Phone

(715) 842-2028

NPI assigned

Apr 28, 2017

Last updated

Feb 16, 2022By 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

Menachem Ruvel

Title

Manager

Phone

(516) 605-9800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1528593399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E WAUSAU AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544033101",
            "telephone_number": "715-842-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E WAUSAU AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54403",
            "telephone_number": "715-842-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BAY AT COLONIAL MANOR HEALTH AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "RUVEL",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-605-9800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.