Healthcare Provider Details

I. General information

NPI: 1881784312
Provider Name (Legal Business Name): BOWLING GREEN INN OF PENSACOLA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2068 HEALTH CARE AVE
NAVARRE FL
32566-2901
US

IV. Provider business mailing address

6100 TOWER CIR STE 1000
FRANKLIN TN
37067-1509
US

V. Phone/Fax

Practice location:
  • Phone: 850-939-1200
  • Fax: 850-939-1257
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number0157AD552301
License Number StateFL

VIII. Authorized Official

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