Provider Demographics
NPI:1740766807
Name:BEVERLY HOME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BEVERLY HOME HEALTHCARE SERVICES
Other - Org Name:BRIGHTSTAR CARE OF COLUMBIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JE
Authorized Official - Last Name:NEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-881-7400
Mailing Address - Street 1:1701 DEVONSHIRE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2446
Mailing Address - Country:US
Mailing Address - Phone:803-881-7400
Mailing Address - Fax:803-881-7401
Practice Address - Street 1:1701 DEVONSHIRE DR STE 102
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2446
Practice Address - Country:US
Practice Address - Phone:803-881-7400
Practice Address - Fax:803-881-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-12
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health