BAYSIDE CARE CENTER LP
NPI 1407669674
Intermediate Care Facility, Mental Illness in Waukegan, IL

NPI Status: Active since January 30, 2025

Contact Information

1100 S LEWIS AVE
WAUKEGAN, IL
ZIP 60085
Phone: (847) 244-8196

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  • Organization
  • Intermediate Care Facility, Mental Illne...
  • CLIA Number: 14D0675295
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About BAYSIDE CARE CENTER LP

This page provides the complete NPI Profile along with additional information for Bayside Care Center Lp, a provider established in Waukegan, Illinois operating as a Intermediate Care Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1407669674 assigned on January 2025. The practitioner's primary taxonomy code is 310500000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Kim M Boulton (Contract Coordinator)

NPI
1407669674
Provider Name
BAYSIDE CARE CENTER LP
Entity Type
Organization
Location Address
1100 S LEWIS AVE WAUKEGAN, IL 60085
Location Phone
(847) 244-8196
Mailing Address
5151 CHURCH ST SKOKIE, IL 60077
Mailing Phone
(847) 933-9200
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-30-2025
Last Update Date
01-30-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Mental Illness

Taxonomy Code
310500000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KIM M BOULTON

Authorized Official Title
CONTRACT COORDINATOR
Authorized Official Phone
(847) 933-9200

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D0675295
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
RIA NAVARRO
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bayside Care Center Lp to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1407669674, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
0
Doubled → 0
Pos 4
7
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
6
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 6 → 12 → 3 9 → 18 → 9 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 0 + 7 + 1 + 2 + 6 + 1 + 8 + 6 + 1 + 4 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1407669674.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Intermediate Care Facility, Mental Illness
1100 S LEWIS AVE
WAUKEGAN, IL 60085

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407669674, enumerated as an "organization" on January 30, 2025.

The provider is located at 1100 S LEWIS AVE WAUKEGAN, IL 60085 and the phone number is (847) 244-8196.

Intermediate Care Facility, Mental Illness with taxonomy code 310500000X.