Provider Demographics
NPI:1720494255
Name:B-COLL ENTERPRISES L.L.C.
Entity Type:Organization
Organization Name:B-COLL ENTERPRISES L.L.C.
Other - Org Name:COLLINS THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:313-605-2216
Mailing Address - Street 1:2404 CORNELL ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2503
Mailing Address - Country:US
Mailing Address - Phone:313-605-2216
Mailing Address - Fax:
Practice Address - Street 1:2404 CORNELL ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2503
Practice Address - Country:US
Practice Address - Phone:313-605-2216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL237914251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health