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General NPI Number Information
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NPI Number | 1023704954
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Entity Type | Organization
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Legal Business Name | BLUE BELL MANAGEMENT LLC
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 107 E 1ST ST
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City | CASA GRANDE
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State | AZ
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Zip | 85122-5201
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Country | US
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Telephone | 520-375-2682
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Fax |
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Provider Business Mailing Address
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Address Line | 2487 S GILBERT RD STE 106-163
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City | GILBERT
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State | AZ
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Zip | 85295-2808
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Country | US
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Telephone | 520-375-2682
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | LISA TAPIA
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Credential |
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Telephone | 520-375-2682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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