Provider Demographics
NPI: | 1114235884 |
---|---|
Name: | BMG CIRCLE OF LIFE, LLC |
Entity Type: | Organization |
Organization Name: | BMG CIRCLE OF LIFE, LLC |
Other - Org Name: | ALWAYS BEST CARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BRYANT |
Authorized Official - Middle Name: | MATTHEW |
Authorized Official - Last Name: | GREENE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 856-816-8836 |
Mailing Address - Street 1: | 668 WOODBOURNE RD STE 105 |
Mailing Address - Street 2: | |
Mailing Address - City: | LANGHORNE |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19047-1820 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 267-909-9248 |
Mailing Address - Fax: | 267-909-9258 |
Practice Address - Street 1: | 668 WOODBOURNE RD STE 105 |
Practice Address - Street 2: | |
Practice Address - City: | LANGHORNE |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19047-1820 |
Practice Address - Country: | US |
Practice Address - Phone: | 267-909-9248 |
Practice Address - Fax: | 267-909-9258 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-09-16 |
Last Update Date: | 2018-09-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | 19413601 | 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |