Healthcare Provider Details

I. General information

NPI: 1619749033
Provider Name (Legal Business Name): BELLE'S HOULSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 HIGH ST NW
CARROLLTON OH
44615-1137
US

IV. Provider business mailing address

3241 ANTIGUA RD SW
CARROLLTON OH
44615-9273
US

V. Phone/Fax

Practice location:
  • Phone: 419-217-1012
  • Fax: 844-862-7019
Mailing address:
  • Phone: 330-735-1515
  • Fax: 844-862-7019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MINDY LYNN WEILAND
Title or Position: OWNER
Credential:
Phone: 419-217-1012