Provider Demographics
NPI:1730532326
Name:BETHESDA HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:BETHESDA HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:YUDOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-640-8197
Mailing Address - Street 1:100 JEFFERSON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6628
Mailing Address - Country:US
Mailing Address - Phone:202-640-8197
Mailing Address - Fax:
Practice Address - Street 1:5111 69TH PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1544
Practice Address - Country:US
Practice Address - Phone:202-640-8197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health