Provider Demographics
NPI:1538668678
Name:BOWDEN ENTERPRISE SERVICES, LLC
Entity Type:Organization
Organization Name:BOWDEN ENTERPRISE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-242-1139
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:NC
Mailing Address - Zip Code:27807-0411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7341 WINDY CT W
Practice Address - Street 2:
Practice Address - City:BAILEY
Practice Address - State:NC
Practice Address - Zip Code:27807-8953
Practice Address - Country:US
Practice Address - Phone:857-242-1139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28340103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty