Provider Demographics
NPI:1811656846
Name:BETHEL MINDERS GROUP LLC
Entity type:Organization
Organization Name:BETHEL MINDERS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLASUMBO
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYEMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-393-0173
Mailing Address - Street 1:7425 FORBES BLVD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2270
Mailing Address - Country:US
Mailing Address - Phone:240-393-0173
Mailing Address - Fax:
Practice Address - Street 1:7425 FORBES BLVD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2270
Practice Address - Country:US
Practice Address - Phone:240-393-0173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty