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General NPI Number Information
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NPI Number | 1407496334
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Entity Type | Organization
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Legal Business Name | BETHESDA HEALTH AND WELLNESS INC.
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 1244 APPLETON RD STE D
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City | MENASHA
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State | WI
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Zip | 54952-1502
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Country | US
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Telephone | 920-944-8945
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Fax | 920-944-8947
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Provider Business Mailing Address
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Address Line | 1244 APPLETON RD STE D
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City | MENASHA
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State | WI
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Zip | 54952-1502
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Country | US
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Telephone | 920-944-8945
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Fax | 920-944-8947
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Authorized Official
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Title or Position | PRESIDENT AND GENERAL MANAGER
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Name | MR. DONALD MATTHEW MCCARTER
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Credential |
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Telephone | 920-944-7846
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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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