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General NPI Number Information
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NPI Number | 1902453459
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Entity Type | Organization
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Legal Business Name | BRANCHING OFF, INC
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 303 N HERSHEY RD STE B
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City | BLOOMINGTON
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State | IL
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Zip | 61704-7720
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Country | US
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Telephone | 309-808-4409
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Fax |
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Provider Business Mailing Address
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Address Line | 303 N HERSHEY RD STE B
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City | BLOOMINGTON
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State | IL
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Zip | 61704-7720
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Country | US
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Telephone | 309-808-4409
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | BEKIME FEEZOR-BRANCH
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Credential |
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Telephone | 309-750-0558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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