Provider Demographics
NPI:1770131773
Name:BLUEBONNET POINT WELLNESS, LLC
Entity type:Organization
Organization Name:BLUEBONNET POINT WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-281-0078
Mailing Address - Street 1:1523 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-4043
Mailing Address - Country:US
Mailing Address - Phone:318-281-0078
Mailing Address - Fax:318-281-2753
Practice Address - Street 1:151 HERITAGE SPRINGS DRIVE
Practice Address - Street 2:
Practice Address - City:BULLARD
Practice Address - State:TX
Practice Address - Zip Code:75757
Practice Address - Country:US
Practice Address - Phone:318-281-0078
Practice Address - Fax:318-281-2753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility