Provider Demographics
NPI:1619560273
Name:BETORAH HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:BETORAH HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:BISSAINTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-237-4631
Mailing Address - Street 1:398 N 6TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-2314
Mailing Address - Country:US
Mailing Address - Phone:862-237-4631
Mailing Address - Fax:
Practice Address - Street 1:398 N 6TH ST APT 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2314
Practice Address - Country:US
Practice Address - Phone:862-237-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care