Provider Demographics
NPI:1295174241
Name:BEEHIVE HOME CARE
Entity type:Organization
Organization Name:BEEHIVE HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-692-0110
Mailing Address - Street 1:11944 N APOLLO WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3682
Mailing Address - Country:US
Mailing Address - Phone:801-692-0110
Mailing Address - Fax:888-959-9391
Practice Address - Street 1:256 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:UT
Practice Address - Zip Code:84004-1476
Practice Address - Country:US
Practice Address - Phone:801-692-0110
Practice Address - Fax:888-959-9391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2013PCAUT000582253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care