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General NPI Number Information
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NPI Number | 1073719548
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Entity Type | Organization
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Legal Business Name | BELL THERAPY INC CSP SOUTH
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 634 W HISTORIC MITCHELL ST
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City | MILWAUKEE
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State | WI
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Zip | 53204-3512
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Country | US
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Telephone | 414-383-4486
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Fax |
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Provider Business Mailing Address
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Address Line | 634 W HISTORIC MITCHELL ST
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City | MILWAUKEE
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State | WI
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Zip | 53204-3512
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Country | US
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Telephone | 414-383-4486
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OUTPATIENT SERVICES
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Name | ANNE JONES
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Credential | M.S.
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Telephone | 414-871-6122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 1095
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License Number State | WI
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