Healthcare Provider Details

I. General information

NPI: 1457126229
Provider Name (Legal Business Name): BEWEL HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 CLIFTON ST NW APT 100W
WASHINGTON DC
20009-7003
US

IV. Provider business mailing address

725 STRETFORD WAY APT 101
HYATTSVILLE MD
20785-5948
US

V. Phone/Fax

Practice location:
  • Phone: 301-532-6613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH WELLE
Title or Position: CEO
Credential:
Phone: 301-532-6613