Organization · NPI-2
Bethesda Healthcare Services
In Home Supportive Care · Marietta, GA
NPI number1104177427
StatusActive
Last updated in NPPESOct 31, 2012
Details
- NPI
- 1104177427
- Entity type
- Organization (NPI-2)
- Legal business name
- Bethesda Healthcare Services
- Organization subpart
- No
- Enumeration date
- Sep 26, 2012
- Last updated
- Oct 31, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
| 251J00000X | Nursing Care | – | – |
Practice location
2692 Candler Dr SwMarietta, GA 30064-4263
Phone 770-222-9995 · Fax 678-401-8285
Mailing address
Po Box 792Smyrna, GA 30081-0792
Phone 770-222-9995 · Fax 678-401-8285
Authorized official
Reuben Ikeme Onwuzuruoha
Administrator
4042193444
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