Provider Demographics
NPI:1265691547
Name:BERACAH AGENCY LLC
Entity type:Organization
Organization Name:BERACAH AGENCY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CARE COORDINATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:YEOMANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-373-7125
Mailing Address - Street 1:400 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELPRE
Mailing Address - State:OH
Mailing Address - Zip Code:45714-1616
Mailing Address - Country:US
Mailing Address - Phone:740-373-7125
Mailing Address - Fax:740-373-7332
Practice Address - Street 1:400 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1616
Practice Address - Country:US
Practice Address - Phone:740-373-7125
Practice Address - Fax:740-373-7332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care