Bellroad Human Services Inc.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

BELLROAD HUMAN SERVICES INC.

Practice address

182 Bell Rd
Havana, FL 32333-3770

Phone

(850) 539-8510

NPI assigned

Apr 15, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Willie Pease

Title

President

Phone

(850) 539-8510

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1528401023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 BELL RD",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323333770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 BELL RD",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323333770",
            "telephone_number": "850-539-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLROAD HUMAN SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "PEASE",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-539-8510"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140747300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "673567396",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Havana, FL
• Providers in Havana, FL by specialty
• Assisted Living Facility (Mental Illness) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.