Healthcare Provider Details

I. General information

NPI: 1962271676
Provider Name (Legal Business Name): BEULAH HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 WINTERBOURNE DR
UPPER MARLBORO MD
20774-9085
US

IV. Provider business mailing address

3101 WINTERBOURNE DR
UPPER MARLBORO MD
20774-9085
US

V. Phone/Fax

Practice location:
  • Phone: 832-773-0930
  • Fax:
Mailing address:
  • Phone: 832-773-0930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MARY OLADOSU
Title or Position: OWNER
Credential:
Phone: 832-773-0930