Provider Demographics
NPI:1972213007
Name:BEYANA HOMECARE LLC
Entity Type:Organization
Organization Name:BEYANA HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, PHN
Authorized Official - Phone:763-746-6880
Mailing Address - Street 1:10865 KINGSFIELD LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-8351
Mailing Address - Country:US
Mailing Address - Phone:176-374-6688
Mailing Address - Fax:
Practice Address - Street 1:10865 KINGSFIELD LN
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-8351
Practice Address - Country:US
Practice Address - Phone:176-374-6688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty