Provider Demographics
NPI:1508634320
Name:BEA CARE HOME LLC
Entity Type:Organization
Organization Name:BEA CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEATRIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:TRISTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-378-1595
Mailing Address - Street 1:9680 ITASCA CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-4564
Mailing Address - Country:US
Mailing Address - Phone:775-378-1595
Mailing Address - Fax:
Practice Address - Street 1:1060 RAIN WATER CT
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-0891
Practice Address - Country:US
Practice Address - Phone:775-378-1595
Practice Address - Fax:775-502-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home