Provider Demographics
NPI:1023674876
Name:BBJS,LLC
Entity type:Organization
Organization Name:BBJS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:CARTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-875-9805
Mailing Address - Street 1:1320 E ATHERTON RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2812
Mailing Address - Country:US
Mailing Address - Phone:810-875-9805
Mailing Address - Fax:810-875-9805
Practice Address - Street 1:1320 E ATHERTON RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2812
Practice Address - Country:US
Practice Address - Phone:810-875-9805
Practice Address - Fax:810-875-9805
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BBJS,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8786755Medicaid