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General NPI Number Information
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NPI Number | 1992135313
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Entity Type | Organization
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Legal Business Name | BAVARIAN COMFORT CARE
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Dates
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Enumeration Date | 11/21/2013
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Last Update Date | 11/21/2013
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Provider Practice Location Address
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Address Line | 5366 W ROLLING HILLS DR
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City | BRIDGEPORT
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State | MI
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Zip | 48722-9671
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Country | US
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Telephone | 989-777-7776
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Fax | 989-777-7700
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Provider Business Mailing Address
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Address Line | 5366 W ROLLING HILLS DR
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City | BRIDGEPORT
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State | MI
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Zip | 48722-9671
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Country | US
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Telephone | 989-777-7776
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Fax | 989-777-7700
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Authorized Official
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Title or Position | OWNER
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Name | HAMZA SIKANDER
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Credential |
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Telephone | 989-777-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number | AH730327707
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License Number State | MI
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