Provider Demographics
NPI:1215371091
Name:BET HASHEM MIDRASH
Entity type:Organization
Organization Name:BET HASHEM MIDRASH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEAD COACH DIR.
Authorized Official - Prefix:
Authorized Official - First Name:SHMUWAL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHARUWAN WAHLI
Authorized Official - Suffix:
Authorized Official - Credentials:APPROVED PROVIDER NO
Authorized Official - Phone:260-479-9835
Mailing Address - Street 1:13539 US HIGHWAY 24 E
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:IN
Mailing Address - Zip Code:46774-9714
Mailing Address - Country:US
Mailing Address - Phone:260-479-9835
Mailing Address - Fax:260-749-0182
Practice Address - Street 1:13539 US HIGHWAY 24 E
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:IN
Practice Address - Zip Code:46774-9714
Practice Address - Country:US
Practice Address - Phone:260-749-2288
Practice Address - Fax:260-749-0182
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BET HASHEM MIDRASH INC, ARIAL HOLISTIC HEALTH CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20130301-18001173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173C00000XOther Service ProvidersReflexologistGroup - Single Specialty