Provider Demographics
NPI:1275924078
Name:BHS OF KEY LARGO LLC
Entity Type:Organization
Organization Name:BHS OF KEY LARGO LLC
Other - Org Name:SUNSPIRE HEALTH OF KEY LARGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO AND AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-668-4232
Mailing Address - Street 1:19820 N 7TH STREET
Mailing Address - Street 2:SUITE 205, ATTN FINANCE DEPT
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-1688
Mailing Address - Country:US
Mailing Address - Phone:928-684-4039
Mailing Address - Fax:623-581-7624
Practice Address - Street 1:228 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4331
Practice Address - Country:US
Practice Address - Phone:561-409-0107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility