Healthcare Provider Details

I. General information

NPI: 1063518124
Provider Name (Legal Business Name): BETHEL HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7057 SHOUP AVE
WEST HILLS CA
91307-2335
US

IV. Provider business mailing address

7057 SHOUP AVE
WEST HILLS CA
91307-2335
US

V. Phone/Fax

Practice location:
  • Phone: 818-348-8422
  • Fax: 818-348-1940
Mailing address:
  • Phone: 818-348-8422
  • Fax: 818-348-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. SUSAN HENRY
Title or Position: OWNER
Credential:
Phone: 818-348-8422