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Contact Information

BACK DOOR, LLC
1639 CAPE CORAL PKWY E STE 211
CAPE CORAL, FL33904-9657
 Phone: 239-745-5917
 Fax: 866-676-2762
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BACK DOOR, LLC

NPI Number 1982836391
LBN Legal business name BACK DOOR, LLC
Authorized official CHERYL BUSS - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/18/2009
Last updated 11/17/2009 - About 17 years ago
Identifiers
FL License # ME100060
FL License # SW8039
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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