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General NPI Number Information
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NPI Number | 1952690067
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Entity Type | Organization
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Legal Business Name | BV ASSISTED LIVING, INC.
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 2129 W NEW HAVEN AVE
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-3875
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Country | US
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Telephone | 321-724-0060
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Fax | 321-724-8157
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Provider Business Mailing Address
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Address Line | 2129 W NEW HAVEN AVE
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-3875
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Country | US
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Telephone | 321-724-0060
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Fax | 321-724-8157
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DONALD SPALDING
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Credential |
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Telephone | 321-724-0060
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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 | AL8693
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License Number State | FL
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