Healthcare Provider Details

I. General information

NPI: 1821137035
Provider Name (Legal Business Name): BOWLING GREEN INN OF PENSACOLA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7940 N FEDERAL HWY SUITE 120
BOCA RATON FL
33487-1679
US

IV. Provider business mailing address

6100 TOWER CIR STE 1000
FRANKLIN TN
37067-1509
US

V. Phone/Fax

Practice location:
  • Phone: 561-995-7388
  • Fax:
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0950AD552300
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN P FARLEY
Title or Position: VP AND SECRETARY
Credential:
Phone: 615-861-6000