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General NPI Number Information
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NPI Number | 1376747006
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Entity Type | Organization
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Legal Business Name | BELL THERAPY, INC.
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5500 8TH AVE
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City | KENOSHA
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State | WI
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Zip | 53140-3700
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Country | US
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Telephone | 262-546-0067
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Fax | 262-652-1411
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Provider Business Mailing Address
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Address Line | 5500 8TH AVE
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City | KENOSHA
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State | WI
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Zip | 53140-3700
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Country | US
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Telephone | 262-564-0067
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Fax | 262-652-1411
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Authorized Official
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Title or Position | CASE MANAGER
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Name | MS. JEANINE MICHELLE NASH
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Credential | BS, CSW
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Telephone | 262-564-0067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 2615-120
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License Number State | WI
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