Provider Demographics
NPI:1043947518
Name:BSK ENTERPRISES, LLC
Entity Type:Organization
Organization Name:BSK ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:STONEBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-290-8537
Mailing Address - Street 1:5310 CLEMONS RD BLDG 200
Mailing Address - Street 2:
Mailing Address - City:EAST RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3108
Mailing Address - Country:US
Mailing Address - Phone:423-490-0119
Mailing Address - Fax:423-894-6187
Practice Address - Street 1:5310 CLEMONS RD BLDG 200
Practice Address - Street 2:
Practice Address - City:EAST RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37412-3108
Practice Address - Country:US
Practice Address - Phone:423-490-0119
Practice Address - Fax:423-894-6187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility