# ANNIE BETHEL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912421710
- **Authorized official:** STEPHEN AGBONIFO (MANAGER)
- **Authorized official phone:** (817) 891-4688

## Contact information

- **Practice address:** 625 KENMOOR AVE SE STE 350, GRAND RAPIDS, MI 49546-2395
- **Practice address phone:** (832) 403-1815
- **Mailing address:** 9106 HILLS JUNCTION CT, CYPRESS, TX 77433-0039

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/02/2017
- **Last updated:** 08/02/2017