Provider Demographics
NPI:1083036602
Name:BELLA MONTE RECOVERY II LLC
Entity Type:Organization
Organization Name:BELLA MONTE RECOVERY II LLC
Other - Org Name:BELLA MONTE II LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL BILLING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GATLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-671-9803
Mailing Address - Street 1:68111 CALLE LAS TIENDAS
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:68111 CALLE LAS TIENDAS
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6435
Practice Address - Country:US
Practice Address - Phone:954-678-0078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-16
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0405X
324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder