Provider Demographics
NPI:1275873234
Name:BG JAVIER CORPORATION
Entity Type:Organization
Organization Name:BG JAVIER CORPORATION
Other - Org Name:PRETTY POND MANOR ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JAVIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-783-8483
Mailing Address - Street 1:38911 PRETTY POND RD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-1433
Mailing Address - Country:US
Mailing Address - Phone:813-783-8483
Mailing Address - Fax:813-862-2017
Practice Address - Street 1:38911 PRETTY POND RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540-1433
Practice Address - Country:US
Practice Address - Phone:813-783-8483
Practice Address - Fax:813-862-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9295310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility