Healthcare Provider Details

I. General information

NPI: 1184341604
Provider Name (Legal Business Name): BKD PERSONAL ASSISTANCE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FOUNTAIN CT
LONGWOOD FL
32750-4922
US

IV. Provider business mailing address

123 FOUNTAIN CT
LONGWOOD FL
32750-4922
US

V. Phone/Fax

Practice location:
  • Phone: 407-767-1600
  • Fax:
Mailing address:
  • Phone: 407-767-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOANNE K LESKOWICZ
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 414-918-5000