Provider Demographics
NPI:1174852610
Name:BETHEL HEALTH CARE SERVICES,LLC
Entity type:Organization
Organization Name:BETHEL HEALTH CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUSEYE
Authorized Official - Middle Name:O
Authorized Official - Last Name:ADEKUNLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-882-4536
Mailing Address - Street 1:9396 RICHMOND AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3950
Mailing Address - Country:US
Mailing Address - Phone:832-882-4536
Mailing Address - Fax:
Practice Address - Street 1:9396 RICHMOND AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-3950
Practice Address - Country:US
Practice Address - Phone:832-882-4536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities