Provider Demographics
NPI:1962271676
Name:BEULAH HOME HEALTH SERVICES
Entity type:Organization
Organization Name:BEULAH HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLADOSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-773-0930
Mailing Address - Street 1:3101 WINTERBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-9085
Mailing Address - Country:US
Mailing Address - Phone:832-773-0930
Mailing Address - Fax:
Practice Address - Street 1:3101 WINTERBOURNE DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-9085
Practice Address - Country:US
Practice Address - Phone:832-773-0930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty