| Organization Name: | BOPPAS HOME |
| NPI Number: | 1053778480 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETHANN MEYER (OWNER) |
| Mailing Address: | 440 Catalina Ave Nw Palm Bay |
| State: | FL US |
| Postal Code: | 329071835 |
| Phone Number: | 3213275350 |
| Fax Number: | |
| NPI Enumeration Date: | 01/15/2016 |
| NPI Last Update Date: | 01/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | 12106 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |