Provider Demographics
NPI:1144587015
Name:BEULAH HOME SERVICES, INC
Entity Type:Organization
Organization Name:BEULAH HOME SERVICES, INC
Other - Org Name:BHS, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:AKPOTIRIH
Authorized Official - Last Name:ERHIAWARIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:301-502-6011
Mailing Address - Street 1:1407 CAITLIN COURT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:301-502-6011
Mailing Address - Fax:
Practice Address - Street 1:1407 CAITLIN COURT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-502-6011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3186163W00000X, 251E00000X, 3747A0650X, 374U00000X
MDR318GP251E00000X
372500000X, 374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521506400Medicaid
MDR3186OtherCURRENT LICENSE #