Provider Demographics
NPI:1013587542
Name:B & B COMMUNITY IMPACT CENTER
Entity Type:Organization
Organization Name:B & B COMMUNITY IMPACT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:903-805-8788
Mailing Address - Street 1:1438 OXBOW DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-4006
Mailing Address - Country:US
Mailing Address - Phone:504-251-0493
Mailing Address - Fax:
Practice Address - Street 1:1438 OXBOW DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-4006
Practice Address - Country:US
Practice Address - Phone:504-251-0493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty