Provider Demographics
NPI:1861192957
Name:BEULAH HOME CARE, LLC
Entity type:Organization
Organization Name:BEULAH HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND DOO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEBAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-501-8401
Mailing Address - Street 1:1748 RIVERWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:KINGS MILLS
Mailing Address - State:OH
Mailing Address - Zip Code:45034-9766
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1748 RIVERWOOD TRL
Practice Address - Street 2:
Practice Address - City:KINGS MILLS
Practice Address - State:OH
Practice Address - Zip Code:45034-9766
Practice Address - Country:US
Practice Address - Phone:513-501-8401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care