Provider Demographics
NPI:1114794831
Name:BEULAH INTEGRATED HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BEULAH INTEGRATED HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEEKPOA
Authorized Official - Middle Name:BARINUA
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:JR
Authorized Official - Credentials:ETC
Authorized Official - Phone:602-598-9321
Mailing Address - Street 1:1205 W SAINT CATHERINE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-5917
Mailing Address - Country:US
Mailing Address - Phone:602-598-9321
Mailing Address - Fax:
Practice Address - Street 1:1205 W SAINT CATHERINE AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-5917
Practice Address - Country:US
Practice Address - Phone:602-598-9321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health