Provider Demographics
NPI:1790559136
Name:BFW GROUP HOLDINGS LLC
Entity Type:Organization
Organization Name:BFW GROUP HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPONSOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:GALAHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-991-5687
Mailing Address - Street 1:19537 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5262
Mailing Address - Country:US
Mailing Address - Phone:240-654-4001
Mailing Address - Fax:
Practice Address - Street 1:19537 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5262
Practice Address - Country:US
Practice Address - Phone:240-654-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BFW GROUP HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-07
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone