Provider Demographics
NPI:1801970991
Name:BETH EMETH HOME ATTENDANT SERVICE, INC.
Entity type:Organization
Organization Name:BETH EMETH HOME ATTENDANT SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-253-2220
Mailing Address - Street 1:1080 MCDONALD AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2633
Mailing Address - Country:US
Mailing Address - Phone:718-253-2220
Mailing Address - Fax:718-951-7901
Practice Address - Street 1:1080 MCDONALD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2633
Practice Address - Country:US
Practice Address - Phone:718-253-2220
Practice Address - Fax:718-951-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9815L001171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty