Healthcare Provider Details

I. General information

NPI: 1811354947
Provider Name (Legal Business Name): BELL SENIOR SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 10/14/2023
Certification Date: 10/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 RIVERSIDE DR SUITE 103
MACON GA
31204-1285
US

IV. Provider business mailing address

2940 RIVERSIDE DR SUITE 103
MACON GA
31204-1285
US

V. Phone/Fax

Practice location:
  • Phone: 478-477-5501
  • Fax: 478-477-5505
Mailing address:
  • Phone: 478-477-5501
  • Fax: 478-477-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number011-R-0024
License Number StateGA

VIII. Authorized Official

Name: MRS. SHANNON BELL
Title or Position: FRANCHISE OWNER
Credential:
Phone: 478-477-5501