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General NPI Number Information
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NPI Number | 1154517126
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Entity Type | Organization
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Legal Business Name | BEOD HEALTH CARE SERVICES, LLC
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 50 S PICKETT ST STE 210
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City | ALEXANDRIA
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State | VA
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Zip | 22304-7206
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Country | US
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Telephone | 703-751-4397
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Fax | 703-751-4396
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Provider Business Mailing Address
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Address Line | 50 S PICKETT ST STE 210
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City | ALEXANDRIA
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State | VA
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Zip | 22304-7206
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Country | US
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Telephone | 703-751-4397
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Fax | 703-751-4396
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MABEL A YENTUMI
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Credential |
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Telephone | 703-751-4397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 39911-01
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License Number State | VA
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