Provider Demographics
NPI:1013336346
Name:BONAVENTURE HEALTH SERVICES INC.
Entity type:Organization
Organization Name:BONAVENTURE HEALTH SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:YVELINE
Authorized Official - Middle Name:O
Authorized Official - Last Name:BELLANDE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:561-372-4452
Mailing Address - Street 1:123 NW 13TH ST STE 214-05
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-1641
Mailing Address - Country:US
Mailing Address - Phone:561-372-4452
Mailing Address - Fax:877-669-7651
Practice Address - Street 1:123 NW 13TH ST STE 214-05
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1641
Practice Address - Country:US
Practice Address - Phone:561-372-4452
Practice Address - Fax:877-669-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211574313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility