Provider Demographics
NPI:1578656229
Name:BETHHAROLD PRIVATE DUTY CARE INC.
Entity Type:Organization
Organization Name:BETHHAROLD PRIVATE DUTY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,
Authorized Official - Phone:248-423-3300
Mailing Address - Street 1:15565 NORTHLAND DR.
Mailing Address - Street 2:SUITE 403E
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5308
Mailing Address - Country:US
Mailing Address - Phone:248-423-3300
Mailing Address - Fax:248-423-3301
Practice Address - Street 1:15565 NORTHLAND DR.
Practice Address - Street 2:SUITE 403E
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5308
Practice Address - Country:US
Practice Address - Phone:248-423-3300
Practice Address - Fax:248-423-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI154432425Medicare ID - Type UnspecifiedPROVID/PROVIDER ID NUMBER