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General NPI Number Information
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NPI Number | 1942653357
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Entity Type | Organization
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Legal Business Name | BAY AREA RESOURCES LLC
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 07/20/2016
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Provider Practice Location Address
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Address Line | 11537 TANGLE BRANCH LN
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City | GIBSONTON
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State | FL
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Zip | 33534-5348
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Country | US
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Telephone | 727-643-0517
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Fax | 813-252-3443
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Provider Business Mailing Address
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Address Line | 11537 TANGLE BRANCH LN
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City | GIBSONTON
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State | FL
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Zip | 33534-5348
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Country | US
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Telephone | 727-643-0517
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Fax | 813-252-3443
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Authorized Official
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Title or Position | OWNER
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Name | LENOR C HOLSEY
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Credential | M.ED
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Telephone | 727-643-0517
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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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