Provider Demographics
NPI:1093228397
Name:BELLAROSE NURSING AND REHAB CENTER, INC.
Entity Type:Organization
Organization Name:BELLAROSE NURSING AND REHAB CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-985-8400
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-0469
Mailing Address - Country:US
Mailing Address - Phone:919-985-8400
Mailing Address - Fax:919-985-8399
Practice Address - Street 1:200 BELLAROSE LAKE WAY
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7049
Practice Address - Country:US
Practice Address - Phone:919-985-8400
Practice Address - Fax:919-985-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0654314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility