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General NPI Number Information
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NPI Number | 1689483067
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Entity Type | Organization
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Legal Business Name | BEDFORD AL, LLC
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 3008 SHAWNEE DR S
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City | BEDFORD
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State | IN
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Zip | 47421-5282
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Country | US
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Telephone | 812-275-2468
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Fax |
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Provider Business Mailing Address
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Address Line | 3008 SHAWNEE DR S
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City | BEDFORD
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State | IN
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Zip | 47421-5282
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | JONATHAN LITT
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Credential |
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Telephone | 646-844-3603
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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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