Healthcare Provider Details

I. General information

NPI: 1205987187
Provider Name (Legal Business Name): BELL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4065 N 35TH ST
MILWAUKEE WI
53216-1705
US

IV. Provider business mailing address

1744 N FARWELL AVE
MILWAUKEE WI
53202-1806
US

V. Phone/Fax

Practice location:
  • Phone: 414-445-9180
  • Fax: 414-445-5995
Mailing address:
  • Phone: 414-225-4460
  • Fax: 414-225-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number1096
License Number StateWI

VIII. Authorized Official

Name: MR. LEONARD F DZIUBLA
Title or Position: PRESIDENT & CEO
Credential: LCSW
Phone: 414-225-4460