Provider Demographics
NPI:1437539871
Name:BEATTYCARE HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:BEATTYCARE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:EPHEUS
Authorized Official - Last Name:BEATTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-505-6184
Mailing Address - Street 1:6381 LITTLE RIVER TPKE STE 2
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-5002
Mailing Address - Country:US
Mailing Address - Phone:703-665-0780
Mailing Address - Fax:
Practice Address - Street 1:6381 LITTLE RIVER TPKE STE 2
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-5002
Practice Address - Country:US
Practice Address - Phone:703-665-0780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO1512621251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health