Organization
BETHEL FAMILY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EKUNDAYO OLADEHINDE ISRAEL CDS/FMS (ADMINISTRATOR)
(469) 831-4354
Entity
Organization
Contact information
Practice address
206 WATERWOOD DR, WYLIE, TX 75098-7475
(469) 831-4354
(972) 767-4076
Mailing address
206 WATERWOOD DR, WYLIE, TX 75098-7475
(469) 831-4354
(972) 767-4076
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/19/2013
Last updated
08/14/2019
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