Healthcare Provider Details

I. General information

NPI: 1437400033
Provider Name (Legal Business Name): BEWELL REHABILITATION AND COUNSELING GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2012
Last Update Date: 09/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 NE 1ST AVE
HALLANDALE BEACH FL
33009-4230
US

IV. Provider business mailing address

212 NE 1ST AVE
HALLANDALE BEACH FL
33009-4230
US

V. Phone/Fax

Practice location:
  • Phone: 954-367-6261
  • Fax: 954-374-8908
Mailing address:
  • Phone: 954-367-6261
  • Fax: 954-374-8908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARINA M BELL
Title or Position: PRESIDENT
Credential:
Phone: 954-367-6261