Healthcare Provider Details

I. General information

NPI: 1932322211
Provider Name (Legal Business Name): BELL OAKS INC SIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 N MAIN ST
SPRINGHILL LA
71075-3248
US

IV. Provider business mailing address

228 N MAIN
SPRINGHILL LA
71075
US

V. Phone/Fax

Practice location:
  • Phone: 318-539-5691
  • Fax:
Mailing address:
  • Phone: 318-539-5691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number4456
License Number StateLA

VIII. Authorized Official

Name: KATHY B THOMPSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-539-5691