Healthcare Provider Details

I. General information

NPI: 1467450528
Provider Name (Legal Business Name): BNCC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 W CHANSLOR WAY
BLYTHE CA
92225-1246
US

IV. Provider business mailing address

4022 VIA DE LA PAZ
OCEANSIDE CA
92057-7335
US

V. Phone/Fax

Practice location:
  • Phone: 760-922-8176
  • Fax: 760-922-0789
Mailing address:
  • Phone: 760-533-6763
  • Fax: 760-439-5423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. SANDRA W BLESSING
Title or Position: PRESIDENT/OWNER
Credential: RN
Phone: 760-533-6763