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NPI Code Detail

MEDICARE: BETHSAIDA HOME HEALTHCARE SERVICES INC

MEDICARE: BETHSAIDA HOME HEALTHCARE SERVICES INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2001018474OTHERTXDADS

General Provider Information

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

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Directions to “BETHSAIDA HOME HEALTHCARE SERVICES INC ” Practice Location

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