Provider Demographics
NPI:1437505898
Name:B.T. ENTERPRISE
Entity Type:Organization
Organization Name:B.T. ENTERPRISE
Other - Org Name:BTE SERVICE FACILITATORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE FACILITATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-447-9786
Mailing Address - Street 1:5510 CLIFFBROOK CIR
Mailing Address - Street 2:UNIT E
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2429
Mailing Address - Country:US
Mailing Address - Phone:804-447-9786
Mailing Address - Fax:804-447-9786
Practice Address - Street 1:5510 CLIFFBROOK CIR
Practice Address - Street 2:UNIT E
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-2429
Practice Address - Country:US
Practice Address - Phone:804-447-9786
Practice Address - Fax:804-447-9786
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B.T. ENTERPRISE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0182979317Medicaid