Provider Demographics
NPI:1295210409
Name:BAITUL HEMAYAH, INC.
Entity Type:Organization
Organization Name:BAITUL HEMAYAH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOMESTIC VIOLENCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SAIDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SUDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DVS
Authorized Official - Phone:704-247-3790
Mailing Address - Street 1:4301 SHAMROCK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3915
Mailing Address - Country:US
Mailing Address - Phone:704-247-3790
Mailing Address - Fax:
Practice Address - Street 1:4301 SHAMROCK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3915
Practice Address - Country:US
Practice Address - Phone:704-247-3790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management