Provider Demographics
NPI:1336925783
Name:BSA HOME HELP AGENCY
Entity Type:Organization
Organization Name:BSA HOME HELP AGENCY
Other - Org Name:BSA HOME HELP AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO/FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-217-1411
Mailing Address - Street 1:47071 BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-2723
Mailing Address - Country:US
Mailing Address - Phone:248-217-1411
Mailing Address - Fax:
Practice Address - Street 1:47071 BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-2723
Practice Address - Country:US
Practice Address - Phone:248-217-1411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care