Provider Demographics
NPI:1063245082
Name:BT NAPLES OPCO LLC
Entity type:Organization
Organization Name:BT NAPLES OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:WAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-547-2107
Mailing Address - Street 1:821 DONOVAN CT
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618-4819
Mailing Address - Country:US
Mailing Address - Phone:916-547-2107
Mailing Address - Fax:
Practice Address - Street 1:5175 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-4100
Practice Address - Country:US
Practice Address - Phone:916-547-2107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility