Provider Demographics
NPI:1225725344
Name:BRANLO ENTERPRISES, LLC
Entity Type:Organization
Organization Name:BRANLO ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDEKOP
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:360-319-1980
Mailing Address - Street 1:1286 THALEN DR
Mailing Address - Street 2:
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-9314
Mailing Address - Country:US
Mailing Address - Phone:360-319-1980
Mailing Address - Fax:
Practice Address - Street 1:210 MORRIS ST
Practice Address - Street 2:
Practice Address - City:LA CONNER
Practice Address - State:WA
Practice Address - Zip Code:98257-7037
Practice Address - Country:US
Practice Address - Phone:360-305-9716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care