Provider Demographics
NPI:1215359195
Name:BETHEL MANAGEMENT GROUP INC.
Entity Type:Organization
Organization Name:BETHEL MANAGEMENT GROUP INC.
Other - Org Name:BETHEL HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAKYE-DANQUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-746-8566
Mailing Address - Street 1:5901 BROOKLYN BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2532
Mailing Address - Country:US
Mailing Address - Phone:763-746-8566
Mailing Address - Fax:763-537-1688
Practice Address - Street 1:5901 BROOKLYN BLVD STE 107
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-2532
Practice Address - Country:US
Practice Address - Phone:763-746-8566
Practice Address - Fax:763-537-1688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN365299172V00000X, 311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care FacilityGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty