Provider Demographics
NPI:1578144408
Name:BH OF CORAL SPRINGS LLC
Entity Type:Organization
Organization Name:BH OF CORAL SPRINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:GADILOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-351-4032
Mailing Address - Street 1:8664 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7508
Mailing Address - Country:US
Mailing Address - Phone:917-351-4032
Mailing Address - Fax:
Practice Address - Street 1:8664 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7508
Practice Address - Country:US
Practice Address - Phone:917-351-4032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility