Provider Demographics
NPI:1942675822
Name:BEDEN ENTEPRISES LLC
Entity Type:Organization
Organization Name:BEDEN ENTEPRISES LLC
Other - Org Name:ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSOLATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-229-3212
Mailing Address - Street 1:345 WESTPARK WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3902
Mailing Address - Country:US
Mailing Address - Phone:817-229-3212
Mailing Address - Fax:817-799-2831
Practice Address - Street 1:345 WESTPARK WAY
Practice Address - Street 2:SUITE 102
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3902
Practice Address - Country:US
Practice Address - Phone:817-229-3212
Practice Address - Fax:817-799-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility