Stonewall Residential Care, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

751213 Issued in WA

Legal business name

STONEWALL RESIDENTIAL CARE, LLC

Practice address

28921 N. River Estates
Chattaroy, WA 99003

Phone

(509) 413-9129

Fax

(509) 209-5684

NPI assigned

Feb 6, 2014

Last updated

Feb 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Carol Bellar, RN

Title

Owner/Provider

Phone

(509) 413-9129

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391644800000",
    "number": "1700200011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28921 N. RIVER ESTATES",
            "city": "CHATTAROY",
            "state": "WA",
            "postal_code": "99003",
            "telephone_number": "509-413-9129",
            "fax_number": "509-209-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28921 N. RIVER ESTATES",
            "city": "CHATTAROY",
            "state": "WA",
            "postal_code": "99003",
            "telephone_number": "509-413-9129",
            "fax_number": "509-209-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALL RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-06",
        "last_updated": "2014-02-06",
        "status": "A",
        "authorized_official_last_name": "BELLAR",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "509-413-9129",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WA",
            "license": "751213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Chattaroy, WA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.