Bethany Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BETHANY HOME CARE LLC

Practice address

505 N Dubuque Ave
Sioux Falls, SD 57110-5792

Phone

(605) 251-6442

NPI assigned

Nov 28, 2020

Last updated

Nov 28, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Queencilia Edmond Ngandu

Title

Manager

Phone

(605) 251-6442

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606521600000",
    "number": "1184228355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N DUBUQUE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571105792",
            "telephone_number": "605-251-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N DUBUQUE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571105792",
            "telephone_number": "605-251-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-28",
        "last_updated": "2020-11-28",
        "certification_date": "2020-11-28",
        "status": "A",
        "authorized_official_last_name": "NGANDU",
        "authorized_official_first_name": "QUEENCILIA",
        "authorized_official_middle_name": "EDMOND",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "605-251-6442"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.