Provider Demographics
NPI:1134382955
Name:BELL-MYRE'S RESIDENTIAL COMMUNITY CARE FACILITY, LLC
Entity type:Organization
Organization Name:BELL-MYRE'S RESIDENTIAL COMMUNITY CARE FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:VIOLA MARIE
Authorized Official - Last Name:BELL-MYRE
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:972-293-1085
Mailing Address - Street 1:1800 MCALISTER ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-4904
Mailing Address - Country:US
Mailing Address - Phone:972-293-1085
Mailing Address - Fax:972-293-1085
Practice Address - Street 1:1800 MCALISTER ST
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-4904
Practice Address - Country:US
Practice Address - Phone:972-293-1085
Practice Address - Fax:972-293-1085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198517310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility