Provider Demographics
NPI:1841047826
Name:BETHEL COMMUNITY HEALTH, LLC
Entity type:Organization
Organization Name:BETHEL COMMUNITY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADLER
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-308-4367
Mailing Address - Street 1:3 ALLIED DR STE 303
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-6148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 ALLIED DR STE 303
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6148
Practice Address - Country:US
Practice Address - Phone:781-308-4367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency