Provider Demographics
NPI:1396379244
Name:BECKETT ENTERPRISE
Entity Type:Organization
Organization Name:BECKETT ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-420-2284
Mailing Address - Street 1:900 KINCAID AVE # K8
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-2021
Mailing Address - Country:US
Mailing Address - Phone:424-420-2284
Mailing Address - Fax:
Practice Address - Street 1:900 KINCAID AVE # K8
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-2021
Practice Address - Country:US
Practice Address - Phone:424-420-2284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-01
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care