Provider Demographics
NPI:1073856597
Name:BAYSHORE ALLIANCE, INC
Entity Type:Organization
Organization Name:BAYSHORE ALLIANCE, INC
Other - Org Name:BRIGHTSTARCARE OF MOBILE E./BALDWIN CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:MAISEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-405-6451
Mailing Address - Street 1:118 N ROYAL ST
Mailing Address - Street 2:SUITE 605
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602-3603
Mailing Address - Country:US
Mailing Address - Phone:251-405-6451
Mailing Address - Fax:251-405-6099
Practice Address - Street 1:118 N ROYAL ST
Practice Address - Street 2:SUITE 605
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-3603
Practice Address - Country:US
Practice Address - Phone:251-405-6451
Practice Address - Fax:251-405-6099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health