Healthcare Provider Details

I. General information

NPI: 1184422743
Provider Name (Legal Business Name): BEULAHCO HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

964 WINTER RUN RD
MIDDLE RIVER MD
21220-1854
US

IV. Provider business mailing address

311 BLACK OPAL DR
JARRELL TX
76537-0818
US

V. Phone/Fax

Practice location:
  • Phone: 443-730-3650
  • Fax:
Mailing address:
  • Phone: 443-730-3650
  • 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: SUNMIBOLA VICTORIA OGUNLEYE
Title or Position: OWNER
Credential:
Phone: 443-730-3650