Healthcare Provider Details

I. General information

NPI: 1649128166
Provider Name (Legal Business Name): BETHEL HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 KELSEY LYNN CT
TOWNSEND DE
19734-2021
US

IV. Provider business mailing address

110 KELSEY LYNN CT
TOWNSEND DE
19734-2021
US

V. Phone/Fax

Practice location:
  • Phone: 215-290-7296
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: MIGGIE EDIAE
Title or Position: CEO
Credential:
Phone: 215-290-7296