Provider Demographics
NPI:1699497867
Name:BRAVO'S HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BRAVO'S HOME CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIYOGUSHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:NON MEDICAL HOME CAR
Authorized Official - Phone:254-535-1934
Mailing Address - Street 1:4099 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2521
Mailing Address - Country:US
Mailing Address - Phone:254-535-1934
Mailing Address - Fax:
Practice Address - Street 1:4099 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2521
Practice Address - Country:US
Practice Address - Phone:254-535-1934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care