MEDICARE: BELL & GOODLOE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720300742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELL & GOODLOE INC.

Provider Business Mailing Address
First Line	:	1176 W LAKE MEAD BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2415
Country	:	US
Telephone Number	:	702-782-1102
Fax Number	:	702-642-6968

Provider Business Practice Location Address
First Line	:	1176 W LAKE MEAD BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2415
Country	:	US
Telephone Number	:	702-782-1102
Fax Number	:	702-642-6968

Authorized Official
Title or Position	:	OWNER/QMA
Name	:	MS. YAVETTE D'NIECE BELL
Credential	:
Telephone Number	:	702-782-1102

Provider Enumeration Date	:	02/17/2010
Last Update Date	:	02/17/2010

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Directions to “BELL & GOODLOE INC. ” Practice Location

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