Provider Demographics
NPI:1083321236
Name:BREAD &BUTTER HOMEMAKER AND COMPANION SERVICES LLC
Entity Type:Organization
Organization Name:BREAD &BUTTER HOMEMAKER AND COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARLOWE
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:850-688-5900
Mailing Address - Street 1:6801 BONNIE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTAHOOCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:32324-2730
Mailing Address - Country:US
Mailing Address - Phone:850-688-5900
Mailing Address - Fax:888-979-8559
Practice Address - Street 1:6801 BONNIE HILL RD
Practice Address - Street 2:
Practice Address - City:CHATTAHOOCHEE
Practice Address - State:FL
Practice Address - Zip Code:32324-2730
Practice Address - Country:US
Practice Address - Phone:850-688-5900
Practice Address - Fax:888-979-8559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114672500Medicaid