Provider Demographics
NPI:1790929032
Name:B&B HOMECARE OF PALM BEACH, LLC
Entity Type:Organization
Organization Name:B&B HOMECARE OF PALM BEACH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:STARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-370-3131
Mailing Address - Street 1:135 NW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7034
Mailing Address - Country:US
Mailing Address - Phone:954-370-3131
Mailing Address - Fax:954-370-3161
Practice Address - Street 1:6421 CONGRESS AVE STE 201
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2859
Practice Address - Country:US
Practice Address - Phone:561-361-4480
Practice Address - Fax:561-361-4475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109608Medicare Oscar/Certification