Provider Demographics
NPI:1548949399
Name:BARKLEY HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:BARKLEY HEALTHCARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MGR
Authorized Official - Prefix:
Authorized Official - First Name:ELBA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-600-7165
Mailing Address - Street 1:31 BARKLEY CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7628
Mailing Address - Country:US
Mailing Address - Phone:239-600-7165
Mailing Address - Fax:239-208-7179
Practice Address - Street 1:31 BARKLEY CIR STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7628
Practice Address - Country:US
Practice Address - Phone:239-600-7165
Practice Address - Fax:239-208-7179
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L23000304817
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty