Provider Demographics
NPI:1083024806
Name:BEECHWOOD HOME HEALTH CORPORATION
Entity Type:Organization
Organization Name:BEECHWOOD HOME HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOKWUAH-NWORAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-974-6666
Mailing Address - Street 1:7100 REGENCY SQUARE BLVD
Mailing Address - Street 2:STE 252
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3202
Mailing Address - Country:US
Mailing Address - Phone:713-974-6666
Mailing Address - Fax:713-974-6667
Practice Address - Street 1:7100 REGENCY SQUARE BLVD
Practice Address - Street 2:STE 252
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3202
Practice Address - Country:US
Practice Address - Phone:713-974-6666
Practice Address - Fax:713-974-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011830251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011830OtherSTATE FACILITY LICENSE
TX011830OtherSTATE FACILITY LICENSE