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General NPI Number Information
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NPI Number | 1881689180
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Entity Type | Organization
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Legal Business Name | BETHEL VISITING NURSE ASSOCIATION INC.
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 70 STONY HILL RD
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City | BETHEL
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State | CT
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Zip | 06801-3036
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Country | US
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Telephone | 203-792-0864
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Fax | 203-730-8053
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Provider Business Mailing Address
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Address Line | 70 STONY HILL RD
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City | BETHEL
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State | CT
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Zip | 06801-3036
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Country | US
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Telephone | 203-792-0864
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Fax | 203-730-8053
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JUDITH L MALIN
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Credential | RN
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Telephone | 203-792-0864
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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 | C805410
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License Number State | CT
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