Provider Demographics
NPI:1164679775
Name:BLTR ENT LLC DBA AFFORDABLE SENIOR HOME CARE
Entity Type:Organization
Organization Name:BLTR ENT LLC DBA AFFORDABLE SENIOR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-279-4495
Mailing Address - Street 1:895 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3084
Mailing Address - Country:US
Mailing Address - Phone:732-279-4495
Mailing Address - Fax:
Practice Address - Street 1:895 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3084
Practice Address - Country:US
Practice Address - Phone:732-279-4495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0081900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health