Provider Demographics
NPI:1538977301
Name:BEAUVAIS HEALTH HOMECARE 3 INC
Entity type:Organization
Organization Name:BEAUVAIS HEALTH HOMECARE 3 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:BEAUVAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-436-5862
Mailing Address - Street 1:594 SW 159TH LN
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1152
Mailing Address - Country:US
Mailing Address - Phone:954-997-5842
Mailing Address - Fax:954-859-6152
Practice Address - Street 1:111 NORTHFIELD AVE STE 208A
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4730
Practice Address - Country:US
Practice Address - Phone:973-436-5862
Practice Address - Fax:973-537-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163WC1400XNursing Service ProvidersRegistered NurseCollege HealthGroup - Multi-Specialty
No364SS0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistSchoolGroup - Multi-Specialty