Provider Demographics
NPI:1477098093
Name:BBL HOLDINGS, LLC
Entity Type:Organization
Organization Name:BBL HOLDINGS, LLC
Other - Org Name:ADVANCED HEARING OF BRIGHTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROUERE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-444-0045
Mailing Address - Street 1:30055 NORTHWESTERN HWY
Mailing Address - Street 2:STE. 101
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3230
Mailing Address - Country:US
Mailing Address - Phone:248-865-4166
Mailing Address - Fax:248-865-4198
Practice Address - Street 1:8023 GRAND RIVER RD
Practice Address - Street 2:400
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9392
Practice Address - Country:US
Practice Address - Phone:810-494-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000441231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty