Provider Demographics
NPI:1700601523
Name:BETTYLIN HOME CARE LLC
Entity type:Organization
Organization Name:BETTYLIN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBELE
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEADUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-535-4337
Mailing Address - Street 1:1473 CARLSEN DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5540
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1473 CARLSEN DR
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5540
Practice Address - Country:US
Practice Address - Phone:732-535-4337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care