Provider Demographics
NPI:1164204293
Name:BETHANY HEALTH CARE LLC
Entity Type:Organization
Organization Name:BETHANY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:RUHORIMBERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-231-0835
Mailing Address - Street 1:1720 ROCKHURST AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1354
Mailing Address - Country:US
Mailing Address - Phone:937-231-0835
Mailing Address - Fax:
Practice Address - Street 1:1720 ROCKHURST AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1354
Practice Address - Country:US
Practice Address - Phone:937-231-0835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty