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General NPI Number Information
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NPI Number | 1134706203
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Entity Type | Organization
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Legal Business Name | TCBB,LLC
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 623 S FEDERAL HWY
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-4935
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Country | US
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Telephone | 561-441-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 623 S FEDERAL HWY
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-4935
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Country | US
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Telephone | 561-441-4720
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES R BURNS
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Credential | NH 4550
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Telephone | 561-441-4720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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