Provider Demographics
NPI:1750997755
Name:BCC THERAPY GROUP INC
Entity type:Organization
Organization Name:BCC THERAPY GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MS SLP
Authorized Official - Phone:787-358-3790
Mailing Address - Street 1:7875 NW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5155
Mailing Address - Country:US
Mailing Address - Phone:787-358-3790
Mailing Address - Fax:
Practice Address - Street 1:7875 NW 11TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5155
Practice Address - Country:US
Practice Address - Phone:787-358-3790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center