Healthcare Provider Details
I. General information
NPI: 1518977149
Provider Name (Legal Business Name): BETTEC LLL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1205 8TH ST
BAKERSFIELD CA
93304-2123
US
IV. Provider business mailing address
17054 ROSEDALE HWY
BAKERSFIELD CA
93314-9485
US
V. Phone/Fax
- Phone: 661-334-2200
- Fax: 661-334-2212
- Phone: 661-589-8443
- Fax: 661-589-8408
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
RONALD
D
O'HAVER
Title or Position: OWNER
Credential:
Phone: 661-589-8443