Provider Demographics
NPI:1366017980
Name:BE HEALED HOMECARE, LLC
Entity Type:Organization
Organization Name:BE HEALED HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBELE
Authorized Official - Middle Name:
Authorized Official - Last Name:IREMEKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-887-0095
Mailing Address - Street 1:175 CANTON ST APT B2
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2228
Mailing Address - Country:US
Mailing Address - Phone:203-887-0095
Mailing Address - Fax:
Practice Address - Street 1:175 CANTON ST APT B2
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2228
Practice Address - Country:US
Practice Address - Phone:203-887-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health