Provider Demographics
NPI:1689428195
Name:BEULAH SERVICES INC
Entity Type:Organization
Organization Name:BEULAH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:OTON
Authorized Official - Last Name:EKONG
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:240-602-7099
Mailing Address - Street 1:6490 LANDOVER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1443
Mailing Address - Country:US
Mailing Address - Phone:240-602-7099
Mailing Address - Fax:240-770-4030
Practice Address - Street 1:6490 LANDOVER RD STE A
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1443
Practice Address - Country:US
Practice Address - Phone:240-602-7099
Practice Address - Fax:240-770-4030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities