Provider Demographics
NPI:1861750648
Name:BEULAH HOME SERVICES, INC
Entity type:Organization
Organization Name:BEULAH HOME SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATIENCE
Authorized Official - Middle Name:AKPOTIRIH
Authorized Official - Last Name:ERHIAWARIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:301-502-6011
Mailing Address - Street 1:1407 CAITLIN COURT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:301-502-6011
Mailing Address - Fax:
Practice Address - Street 1:1407 CAITLIN COURT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-502-6011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
MDR3186P3747A0650X, 374U00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty