Provider Demographics
NPI:1790383172
Name:BEVERLEY'S HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:BEVERLEY'S HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-596-5200
Mailing Address - Street 1:491 BALTIMORE PIKE APT 630
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3810
Mailing Address - Country:US
Mailing Address - Phone:215-596-5200
Mailing Address - Fax:215-596-5200
Practice Address - Street 1:2450 E DEL MAR BLVD UNIT 17
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4809
Practice Address - Country:US
Practice Address - Phone:215-596-5900
Practice Address - Fax:215-596-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care