Provider Demographics
NPI:1043796766
Name:THE SENIOR BELLE, LLC
Entity Type:Organization
Organization Name:THE SENIOR BELLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORFELD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:573-859-3818
Mailing Address - Street 1:183 DEAD LN
Mailing Address - Street 2:
Mailing Address - City:BELLE
Mailing Address - State:MO
Mailing Address - Zip Code:65013-3477
Mailing Address - Country:US
Mailing Address - Phone:573-230-3498
Mailing Address - Fax:
Practice Address - Street 1:801 HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:BELLE
Practice Address - State:MO
Practice Address - Zip Code:65013
Practice Address - Country:US
Practice Address - Phone:573-859-3818
Practice Address - Fax:573-859-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1507261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care