Provider Demographics
NPI:1962512863
Name:MCLAREN BAY SPECIAL CARE
Entity type:Organization
Organization Name:MCLAREN BAY SPECIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-667-6808
Mailing Address - Street 1:3250 E MIDLAND RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2835
Mailing Address - Country:US
Mailing Address - Phone:586-710-8346
Mailing Address - Fax:989-667-6809
Practice Address - Street 1:3250 E MIDLAND RD STE 1
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2835
Practice Address - Country:US
Practice Address - Phone:586-710-8346
Practice Address - Fax:989-667-6809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI232020OtherMEDICARE PROVIDER NUMBER
MI00348OtherBCBSM PROVIDER NUMBER
MI0989307OtherHEALTH PLUS OF MICHIGAN
MI232020OtherMEDICARE PROVIDER NUMBER