Provider Demographics
NPI:1043676430
Name:BEAUTIFUL CARE HOME HEALTH AGENCY, LLC.
Entity type:Organization
Organization Name:BEAUTIFUL CARE HOME HEALTH AGENCY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:NEITHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-477-2502
Mailing Address - Street 1:249 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-3528
Mailing Address - Country:US
Mailing Address - Phone:484-477-2502
Mailing Address - Fax:
Practice Address - Street 1:249 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3528
Practice Address - Country:US
Practice Address - Phone:484-477-2502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health