Provider Demographics
NPI:1518483908
Name:B&G HOME SERVICES LLC
Entity Type:Organization
Organization Name:B&G HOME SERVICES LLC
Other - Org Name:CANDID RESIDENTIAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BABY-LOVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELOISSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-725-9290
Mailing Address - Street 1:12159A SW 132ND CT STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6410
Mailing Address - Country:US
Mailing Address - Phone:305-506-2146
Mailing Address - Fax:
Practice Address - Street 1:12159A SW 132ND CT STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6410
Practice Address - Country:US
Practice Address - Phone:305-506-2146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 261QD1600X
FL234828372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental DisabilitiesGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty