Healthcare Provider Details

I. General information

NPI: 1790362788
Provider Name (Legal Business Name): BEBELYN TOUCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 ELLIOTT AVE
MANSFIELD TX
76063-3700
US

IV. Provider business mailing address

2610 ELLIOTT AVE
MANSFIELD TX
76063-3700
US

V. Phone/Fax

Practice location:
  • Phone: 682-248-9245
  • Fax:
Mailing address:
  • Phone: 682-248-9245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: BOLADALE IGBEKOYI
Title or Position: OWNER, ADMINISTRATOR
Credential:
Phone: 682-248-9245