Provider Demographics
NPI:1588446421
Name:BETHEL HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:BETHEL HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:THATAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-285-0577
Mailing Address - Street 1:3875 POWDER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1292
Mailing Address - Country:US
Mailing Address - Phone:413-285-0577
Mailing Address - Fax:
Practice Address - Street 1:3875 POWDER RIDGE RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1292
Practice Address - Country:US
Practice Address - Phone:413-285-0577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care