Healthcare Provider Details

I. General information

NPI: 1205750528
Provider Name (Legal Business Name): BETHLEHEM HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7740 S TOWNSLEY AVE UNIT 2
SIOUX FALLS SD
57108-7660
US

IV. Provider business mailing address

7740 S TOWNSLEY AVE UNIT 2
SIOUX FALLS SD
57108-7660
US

V. Phone/Fax

Practice location:
  • Phone: 612-601-6906
  • Fax: 612-601-6906
Mailing address:
  • Phone: 612-601-6906
  • Fax: 612-601-6906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PETER B BEYAN
Title or Position: OWNER
Credential:
Phone: 612-601-6906