MEDICARE: BETHEL HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063518124
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETHEL HEALTHCARE INC

Provider Business Mailing Address
First Line	:	7057 SHOUP AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2335
Country	:	US
Telephone Number	:	818-348-8422
Fax Number	:	818-348-1940

Provider Business Practice Location Address
First Line	:	7057 SHOUP AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2335
Country	:	US
Telephone Number	:	818-348-8422
Fax Number	:	818-348-1940

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SUSAN HENRY
Credential	:
Telephone Number	:	818-348-8422

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/22/2020

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