Healthcare Provider Details

I. General information

NPI: 1245142751
Provider Name (Legal Business Name): BELLYFULL CAFE & CATERING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 N HENRY BLVD STE 280
STOCKBRIDGE GA
30281-3680
US

IV. Provider business mailing address

4340 N HENRY BLVD STE 280
STOCKBRIDGE GA
30281-3680
US

V. Phone/Fax

Practice location:
  • Phone: 678-462-9027
  • Fax:
Mailing address:
  • Phone: 678-462-9027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: TAMARA BRIDGES
Title or Position: CEO
Credential:
Phone: 678-462-9027