Provider Demographics
NPI:1912601097
Name:BETHEL HOME CARE LLC
Entity Type:Organization
Organization Name:BETHEL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ABU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-598-6203
Mailing Address - Street 1:2040 OAKLAND PARK AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3848
Mailing Address - Country:US
Mailing Address - Phone:614-598-6203
Mailing Address - Fax:
Practice Address - Street 1:2040 OAKLAND PARK AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3848
Practice Address - Country:US
Practice Address - Phone:614-598-6203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health