Provider Demographics
NPI:1811209943
Name:COMMUNITY BREAD BASKET, INC.
Entity Type:Organization
Organization Name:COMMUNITY BREAD BASKET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MILANESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-797-9884
Mailing Address - Street 1:PO BOX 154
Mailing Address - Street 2:3501 WEST STREET
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-0154
Mailing Address - Country:US
Mailing Address - Phone:304-748-7595
Mailing Address - Fax:304-748-7530
Practice Address - Street 1:3501 WEST ST
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4524
Practice Address - Country:US
Practice Address - Phone:304-748-7595
Practice Address - Fax:304-748-7530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care