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NPI Code Detail

MEDICARE: BETHANY SUPPORT SERVICES, LLC

MEDICARE: BETHANY SUPPORT SERVICES, LLC
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
1251C00000XDevelopmentally Disabled Services Day Training AgencyKS
2251E00000XHome Health Agency1440301101KS
3251S00000XCommunity/Behavioral Health Agency
43747P1801XPersonal Care AttendantKS

General Provider Information

NPI Number : 1164645081
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETHANY SUPPORT SERVICES, LLC
Provider Business Mailing Address
First Line : 313 MUSE ST
Second Line :
City : NEWTON
State : KS
Zip : 67114-3829
Country : US
Telephone Number : 316-283-0843
Fax Number :
Provider Business Practice Location Address
First Line : 313 MUSE ST
Second Line :
City : NEWTON
State : KS
Zip : 67114-3829
Country : US
Telephone Number : 316-283-0843
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : ANGELA SUE MILLER
Credential :
Telephone Number : 316-283-0843
Provider Enumeration Date : 04/10/2007
Last Update Date : 04/10/2008

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