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General NPI Number Information
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NPI Number | 1932394699
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Entity Type | Organization
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Legal Business Name | BRIDGEPORT HOME HEALTH CARE-PRIVATE, INC.
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 10661 AIRPORT PULLING RD N SUITE 9
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City | NAPLES
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State | FL
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Zip | 34109-7335
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Country | US
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Telephone | 239-262-5002
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Fax | 239-514-1699
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Provider Business Mailing Address
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Address Line | 10661 AIRPORT PULLING RD N SUITE 9
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City | NAPLES
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State | FL
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Zip | 34109-7335
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Country | US
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Telephone | 239-262-5002
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Fax | 239-514-1699
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Authorized Official
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Title or Position | CEO
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Name | NANCY DILLER-SHIVELY
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Credential |
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Telephone | 330-621-2721
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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 |
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License Number State |
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