Provider Demographics
NPI:1528790854
Name:BEULAH HOME CARE LLC
Entity type:Organization
Organization Name:BEULAH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:RASHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:AZAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-300-3430
Mailing Address - Street 1:804 SAINT SOLANGE LN
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4456
Mailing Address - Country:US
Mailing Address - Phone:408-300-3430
Mailing Address - Fax:
Practice Address - Street 1:804 SAINT SOLANGE LN
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4456
Practice Address - Country:US
Practice Address - Phone:408-300-3430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care