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General NPI Number Information
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NPI Number | 1891331427
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Entity Type | Organization
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Legal Business Name | BUBBSH LLC
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Dates
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Enumeration Date | 11/19/2019
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 370 BLARNEY ST
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-3751
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Country | US
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Telephone | 720-295-3488
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Fax | 413-487-9013
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Provider Business Mailing Address
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Address Line | 370 BLARNEY ST
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-3751
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Country | US
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Telephone | 720-295-3488
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Fax | 413-487-9013
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Authorized Official
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Title or Position | PARTNER IN ALF
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Name | MR. CHRISTOPHER DAVID BEERS
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Credential |
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Telephone | 941-628-0635
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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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