Healthcare Provider Details

I. General information

NPI: 1013643519
Provider Name (Legal Business Name): BEBU HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 N LA BREA AVE
INGLEWOOD CA
90302-2207
US

IV. Provider business mailing address

971 N LA BREA AVE
INGLEWOOD CA
90302-2207
US

V. Phone/Fax

Practice location:
  • Phone: 310-910-0588
  • Fax:
Mailing address:
  • Phone: 310-910-0588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. AGEGNEHU A CHEKOL
Title or Position: OFFICER
Credential:
Phone: 310-910-0588