Provider Demographics
NPI:1316182421
Name:BBWK ENTERPRISES LLC
Entity Type:Organization
Organization Name:BBWK ENTERPRISES LLC
Other - Org Name:NEW LIFE HOME HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENOY
Authorized Official - Middle Name:W
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-761-3223
Mailing Address - Street 1:PO BOX 2009
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-2009
Mailing Address - Country:US
Mailing Address - Phone:940-761-3223
Mailing Address - Fax:940-761-3298
Practice Address - Street 1:1106 TRAVIS ST
Practice Address - Street 2:SUITE 130
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4676
Practice Address - Country:US
Practice Address - Phone:940-761-3223
Practice Address - Fax:940-761-3298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747523Medicare Oscar/Certification