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General NPI Number Information
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NPI Number | 1124885702
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Entity Type | Organization
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Legal Business Name | B&B CARE LLC
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Dates
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Enumeration Date | 02/29/2024
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Last Update Date | 03/02/2024
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Provider Practice Location Address
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Address Line | 5200 W 98TH ST APT 314
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City | BLOOMINGTON
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State | MN
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Zip | 55437-2067
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Country | US
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Telephone | 612-406-0890
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 W 98TH ST APT 314
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City | BLOOMINGTON
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State | MN
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Zip | 55437-2067
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Country | US
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Telephone | 612-406-0890
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED AGENT
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Name | BAYAAN MIKAIL BOOKER
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Credential |
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Telephone | 612-406-0890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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