From Boys to Men Group Home LLC

Primary specialty

Adult CompanionTaxonomy code 372600000X

Legal business name

FROM BOYS TO MEN GROUP HOME LLC

Practice address

1403 Shadow Creek PL
Brandon, FL 33510-2454

Phone

(239) 357-0745

NPI assigned

May 30, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jonathan Blanc

Title

Owner

Phone

(239) 357-0745

Specialties & licenses 1

Addresses

Other names 1

• JONATHAN BLANC Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1710870613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 SHADOW CREEK PL",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102454",
            "telephone_number": "239-357-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 SHADOW CREEK PL",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102454",
            "telephone_number": "239-357-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FROM BOYS TO MEN GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-30",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "BLANC",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-357-0745"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JONATHAN BLANC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Adult Companion in Brandon, FL
• Providers in Brandon, FL by specialty
• Adult Companion in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.