Provider Demographics
NPI:1891331427
Name:BUBBSH LLC
Entity Type:Organization
Organization Name:BUBBSH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER IN ALF
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BEERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-628-0635
Mailing Address - Street 1:370 BLARNEY ST
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-3751
Mailing Address - Country:US
Mailing Address - Phone:720-295-3488
Mailing Address - Fax:413-487-9013
Practice Address - Street 1:370 BLARNEY ST
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-3751
Practice Address - Country:US
Practice Address - Phone:720-295-3488
Practice Address - Fax:413-487-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility