Provider Demographics
NPI:1285105304
Name:BETH SENIOR CARE
Entity type:Organization
Organization Name:BETH SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:GARNER
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:251-351-3647
Mailing Address - Street 1:6658 MAUVILLA DR W
Mailing Address - Street 2:
Mailing Address - City:EIGHT MILE
Mailing Address - State:AL
Mailing Address - Zip Code:36613-9345
Mailing Address - Country:US
Mailing Address - Phone:251-679-8004
Mailing Address - Fax:
Practice Address - Street 1:6658 MAUVILLA DR W
Practice Address - Street 2:
Practice Address - City:EIGHT MILE
Practice Address - State:AL
Practice Address - Zip Code:36613-9345
Practice Address - Country:US
Practice Address - Phone:251-679-8004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELIZABETH WILLIAMS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health