Provider Demographics
NPI:1265854319
Name:BD HOME CARE HOLDINGS, LLC
Entity Type:Organization
Organization Name:BD HOME CARE HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GAVIN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-608-7566
Mailing Address - Street 1:7365 CARNELIAN ST
Mailing Address - Street 2:SUITE 116A
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1158
Mailing Address - Country:US
Mailing Address - Phone:909-608-7566
Mailing Address - Fax:
Practice Address - Street 1:7365 CARNELIAN ST
Practice Address - Street 2:SUITE 116A
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1158
Practice Address - Country:US
Practice Address - Phone:909-608-7566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health