Organization
BETHEL HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A. KERN BBA, MBA, CPA (CFO/TREASURER)
(920) 232-5220
Entity
Organization
Contact information
Practice address
225 N EAGLE ST, OSHKOSH, WI 54902-4125
(920) 235-4653
(920) 235-2771
Mailing address
225 N EAGLE ST, OSHKOSH, WI 54902-4125
(920) 235-4653
(920) 235-2771
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2005
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20127400
—
WI
Enumeration date
04/10/2006
Last updated
07/28/2010
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