Provider Demographics
NPI:1447659735
Name:BETHANN PERCY
Entity type:Organization
Organization Name:BETHANN PERCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HHA/STNA
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETHANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-614-4354
Mailing Address - Street 1:811 E PATTERSON ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-1941
Mailing Address - Country:US
Mailing Address - Phone:330-614-4354
Mailing Address - Fax:
Practice Address - Street 1:811 E PATTERSON ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-1941
Practice Address - Country:US
Practice Address - Phone:330-614-4354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400769330608251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0099046Medicaid
OHCS1423200209OtherCARESOURCE