Healthcare Provider Details

I. General information

NPI: 1740471333
Provider Name (Legal Business Name): BETHAL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 TOWERVIEW LN
MISSOURI CITY TX
77489-2433
US

IV. Provider business mailing address

7315 TOWERVIEW LN
MISSOURI CITY TX
77489-2433
US

V. Phone/Fax

Practice location:
  • Phone: 281-437-2956
  • Fax: 281-416-2190
Mailing address:
  • Phone: 281-437-2956
  • Fax: 281-416-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. LEWIS CHARLES
Title or Position: OWNER
Credential:
Phone: 281-437-2956