Provider Demographics
NPI:1588357644
Name:BW DALEA ENTERPRISES, LLC
Entity type:Organization
Organization Name:BW DALEA ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAGE
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:BOARDINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MBA
Authorized Official - Phone:828-458-7043
Mailing Address - Street 1:227 NUT HATCH LOOP
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-8103
Mailing Address - Country:US
Mailing Address - Phone:828-458-7043
Mailing Address - Fax:
Practice Address - Street 1:30 DALEA DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-1686
Practice Address - Country:US
Practice Address - Phone:828-298-7592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)