Provider Demographics
NPI:1407186158
Name:ECUMEN PROPERTIES INC.
Entity Type:Organization
Organization Name:ECUMEN PROPERTIES INC.
Other - Org Name:BETHANY HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:KVIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-762-1567
Mailing Address - Street 1:1020 LARK ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-2219
Mailing Address - Country:US
Mailing Address - Phone:320-762-1567
Mailing Address - Fax:320-762-5316
Practice Address - Street 1:1020 LARK ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-2219
Practice Address - Country:US
Practice Address - Phone:320-762-1567
Practice Address - Fax:320-762-5316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN339992310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
245434Medicare Oscar/Certification