Provider Demographics
NPI:1952988842
Name:BETHANY HOME, INC
Entity Type:Organization
Organization Name:BETHANY HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:BIRLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-589-4501
Mailing Address - Street 1:1863 BETHANY RD
Mailing Address - Street 2:
Mailing Address - City:WOMELSDORF
Mailing Address - State:PA
Mailing Address - Zip Code:19567-9214
Mailing Address - Country:US
Mailing Address - Phone:610-589-4501
Mailing Address - Fax:
Practice Address - Street 1:1863 BETHANY RD
Practice Address - Street 2:
Practice Address - City:WOMELSDORF
Practice Address - State:PA
Practice Address - Zip Code:19567-9214
Practice Address - Country:US
Practice Address - Phone:610-589-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children