Organization
BAY AREA HEALTHCARE ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESHAE MARTIN (CHIEF EXECUTIVE OFFICER)
(813) 938-0040
Entity
Organization
Contact information
Practice address
2105 ROANOKE SPRINGS DR, RUSKIN, FL 33570-6312
(813) 938-0040
Mailing address
2105 ROANOKE SPRINGS DR, RUSKIN, FL 33570-6312
(813) 938-0040
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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