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General NPI Number Information
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NPI Number | 1386631240
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Entity Type | Organization
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Legal Business Name | BETHEL HOME AND SERVICES, INC.
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 614 SOUTH ROCK AVENUE
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City | VIROQUA
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State | WI
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Zip | 54665-1936
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Country | US
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Telephone | 608-637-2171
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Fax | 608-637-8303
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Provider Business Mailing Address
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Address Line | 614 SOUTH ROCK AVENUE
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City | VIROQUA
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State | WI
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Zip | 54665-1936
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Country | US
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Telephone | 608-637-6355
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Fax | 608-637-8303
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Authorized Official
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Title or Position | OPERATIONS TEAM LAND
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Name | MS. DEBRA KAY STOUT TEWALT
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Credential | CSW
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Telephone | 608-637-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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