Provider Demographics
NPI:1023312824
Name:BBLB PROPERTIES LLC
Entity type:Organization
Organization Name:BBLB PROPERTIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-656-9883
Mailing Address - Street 1:18521 E QUEEN CREEK RD STE 105-432
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5845
Mailing Address - Country:US
Mailing Address - Phone:480-656-9883
Mailing Address - Fax:480-888-7025
Practice Address - Street 1:18521 E QUEEN CREEK RD STE 105-432
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5845
Practice Address - Country:US
Practice Address - Phone:480-656-9883
Practice Address - Fax:480-888-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care