MEDICARE: BELLVIEW1CLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	CLA	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689923203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLVIEW1CLA

Provider Business Mailing Address
First Line	:	1552 FORT MORRIS RD
Second Line	:
City	:	MIDWAY
State	:	GA
Zip	:	31320-6213
Country	:	US
Telephone Number	:	912-884-6899
Fax Number	:	912-884-6898

Provider Business Practice Location Address
First Line	:	1552 FORT MORRIS RD
Second Line	:
City	:	MIDWAY
State	:	GA
Zip	:	31320-6213
Country	:	US
Telephone Number	:	912-884-6899
Fax Number	:	912-884-6898

Authorized Official
Title or Position	:	CEO
Name	:	MRS. OLIVIA GRAHAM FULLER
Credential	:
Telephone Number	:	912-884-5474

Provider Enumeration Date	:	08/29/2012
Last Update Date	:	08/29/2012

Similar Medicare Providers

1811846777 — JUSTIN ALLEN
Practice Location Address:

90 BUTLER ST STE A
MIDWAY, GA
31320-4294

Practice Phone: 912-884-9255
Practice Fax: 912-884-9257

1811986003 — TRAIANA DACIANA PACURAR M.D.
Practice Location Address:

586 ISLANDS HIGHWAY
MIDWAY, GA
31320

Practice Phone: 912-396-7050
Practice Fax: 912-884-4197

1255302733 — WOODLAND HEALTH CARE LLC
Practice Location Address:

652 N COASTAL HWY 17
MIDWAY, GA
31320

Practice Phone: 912-884-3361
Practice Fax: 912-884-5730

1285643320 — BETTY JANE LONG
Practice Location Address:

204 BUTLER AVE
MIDWAY, GA
31320

Practice Phone: 912-884-9255
Practice Fax:

1841304383 — THERON GLENN FOX JR.
Practice Location Address:

204 BUTLER AVE
MIDWAY, GA
31320

Practice Phone: 912-884-9255
Practice Fax:

1811090905 — PRIME CARE MEDICAL SERVICES INC
Practice Location Address:

242 SOUTH COASTAL HWY 17
MIDWAY, GA
31320-5231

Practice Phone: 912-884-3444
Practice Fax: 912-884-3456

Directions to “BELLVIEW1CLA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.