Organization · NPI-2

Beulah Home Health Agency INC

Home Health · Tyler, TX

NPI number1942594940
StatusActive
Last updated in NPPESSep 20, 2023

Details

NPI
1942594940
Entity type
Organization (NPI-2)
Legal business name
Beulah Home Health Agency INC
Organization subpart
No
Enumeration date
Jun 7, 2011
Certification date
Sep 20, 2023
Last updated
Sep 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health––Yes

Practice location

3613 Rock Creek Dr
Tyler, TX 75707-1635

Phone 903-525-9037 · Fax 903-525-9076

Mailing address

3613 Rock Creek Dr
Tyler, TX 75707-1635

Phone 903-525-9037 · Fax 903-525-9076

Authorized official

Vincent Udosen
Pres
9035259037

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