Provider Demographics
NPI:1497176796
Name:BCRL CORPORATION
Entity Type:Organization
Organization Name:BCRL CORPORATION
Other - Org Name:BCRL CORP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHYM
Authorized Official - Middle Name:LASALA
Authorized Official - Last Name:BRINAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:219-322-7192
Mailing Address - Street 1:211 MATTESON ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1569
Mailing Address - Country:US
Mailing Address - Phone:219-322-7192
Mailing Address - Fax:219-322-7759
Practice Address - Street 1:211 MATTESON ST
Practice Address - Street 2:SUITE A
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1569
Practice Address - Country:US
Practice Address - Phone:219-322-7192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-04
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health