Bellflower Lane

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-060-575 Issued in NC

Legal business name

BELLFLOWER LANE

Practice address

3124 Milton Rd
Suite 231
Charlotte, NC 28215-5008

Phone

(704) 566-6134

Fax

(704) 566-6136

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Clarissa Henry, BA QP QSAPP

Title

Director Business Development

Phone

(704) 566-6134

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Bellflower Lane2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Rockwood Forest

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Charlotte, NC
  • NPI 1467521781
  NPD tax ID

Locations

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710056742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480794",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282695323",
            "telephone_number": "704-566-6134",
            "fax_number": "704-566-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 MILTON RD",
            "address_2": "SUITE 231",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282155008",
            "telephone_number": "704-566-6134",
            "fax_number": "704-566-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLFLOWER LANE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_title_or_position": "DIRECTOR BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "704-566-6134",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BA QP QSAPP"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-060-575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603949",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ross Joseph Bellavia, M.D.
• Belle Home Health Care LLC
• Beverly Ann Vanessa Belle, MD
• Milca Bellegarde, CCC-SLP
• Christopher Beller, D.C.
• Jackson T Bellis, DPT
• Gabriella Bellitto
• Aimee Ryan Bellmore, LPC, PHD
• Emily Faye Bellow, FNP-C
• Alison Bellows, M.ED, LCMHCA, NCC

• Emotionally Disturbed Childrens' Residential Treatment Facility in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.