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General NPI Number Information
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NPI Number | 1740422567
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Entity Type | Organization
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Legal Business Name | BETHSAIDA HOME HEALTHCARE SERVICES INC
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 3727 DILIDO RD SUITE 136
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City | DALLAS
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State | TX
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Zip | 75228-5531
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Country | US
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Telephone | 214-445-0742
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Fax | 214-445-6307
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Provider Business Mailing Address
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Address Line | 3727 DILIDO RD SUITE 136
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City | DALLAS
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State | TX
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Zip | 75228-5531
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Country | US
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Telephone | 214-445-0742
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Fax | 214-445-6307
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MISS COMFORT EKPENYONG
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Credential | MSW
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Telephone | 214-869-8824
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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 |
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License Number State |
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