Bravo Zulu Companion Care LLC

Key facts

NPI

1497589758

Entity type

Organization (NPI type 2)

Primary specialty

In Home Supportive Care Agency 253Z00000X

Legal business name

BRAVO ZULU COMPANION CARE LLC

Practice address

120 Wellington Dr
Weddington, NC 28104-6012

Phone

(727) 512-2442

NPI assigned

Aug 29, 2024

Organization subpart

No

Authorized official

Name

Laura B Mayo

Title

Owner/Site Supervisor

Phone

(727) 512-2442

National Provider Directory

Specialties & licenses

Addresses

Other names

• Bravo Zulu Home Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 29, 2024.

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1497589758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WELLINGTON DR",
            "city": "WEDDINGTON",
            "state": "NC",
            "postal_code": "281046012",
            "telephone_number": "727-512-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WELLINGTON DR",
            "city": "WEDDINGTON",
            "state": "NC",
            "postal_code": "281046012",
            "telephone_number": "727-512-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO ZULU COMPANION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/SITE SUPERVISOR",
        "authorized_official_telephone_number": "727-512-2442"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bravo Zulu Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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