Healthcare Provider Details

I. General information

NPI: 1720117161
Provider Name (Legal Business Name): BNG ASSOCIATES & BNG ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2007
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

178 GREEN ST
FRANKLIN NC
28734-2516
US

IV. Provider business mailing address

PO BOX 3198
NEW YORK NY
10027-8827
US

V. Phone/Fax

Practice location:
  • Phone: 828-524-9956
  • Fax:
Mailing address:
  • Phone: 917-602-0156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BRIAN GIBSON
Title or Position: DIRECTOR
Credential:
Phone: 917-602-0156