Provider Demographics
NPI:1073052544
Name:BELLA MENTE PSC
Entity Type:Organization
Organization Name:BELLA MENTE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MH
Authorized Official - Prefix:
Authorized Official - First Name:MEGHANN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-735-3555
Mailing Address - Street 1:1415 E US HIGHWAY 169
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3375
Mailing Address - Country:US
Mailing Address - Phone:888-735-3555
Mailing Address - Fax:888-291-6818
Practice Address - Street 1:1415 E US HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3375
Practice Address - Country:US
Practice Address - Phone:888-735-3555
Practice Address - Fax:888-291-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health