Provider Demographics
NPI:1891228201
Name:BLUEFIELD, LLC
Entity Type:Organization
Organization Name:BLUEFIELD, LLC
Other - Org Name:SENIORS' CHOICE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:STINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-674-3553
Mailing Address - Street 1:6350 BAYCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-7550
Mailing Address - Country:US
Mailing Address - Phone:763-546-1599
Mailing Address - Fax:
Practice Address - Street 1:6350 BAYCLIFFE RD
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-7550
Practice Address - Country:US
Practice Address - Phone:763-546-1599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care