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General NPI Number Information
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NPI Number | 1245531847
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Entity Type | Organization
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Legal Business Name | B.L.T. & ASSOCIATES
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Dates
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Enumeration Date | 11/12/2010
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Last Update Date | 11/12/2010
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Provider Practice Location Address
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Address Line | 1555 LAKE AVE
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City | SOUTH SIOUX CITY
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State | NE
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Zip | 68776-5414
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Country | US
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Telephone | 712-253-1616
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Fax | 712-258-3247
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Provider Business Mailing Address
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Address Line | 1555 LAKE AVE
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City | SOUTH SIOUX CITY
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State | NE
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Zip | 68776-5414
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Country | US
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Telephone | 712-253-1616
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Fax | 712-258-3247
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Authorized Official
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Title or Position | SECRETARY
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Name | BARB BEERMANN
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Credential | RN
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Telephone | 712-253-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 095216
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License Number State | IA
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