Provider Demographics
NPI:1164007258
Name:SOUTHERN BELLE RECOVERY LLC
Entity Type:Organization
Organization Name:SOUTHERN BELLE RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-604-0687
Mailing Address - Street 1:621 GREEN MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:OVILLA
Mailing Address - State:TX
Mailing Address - Zip Code:75154-1474
Mailing Address - Country:US
Mailing Address - Phone:501-542-2209
Mailing Address - Fax:
Practice Address - Street 1:621 GREEN MEADOWS LN
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-1474
Practice Address - Country:US
Practice Address - Phone:501-542-2209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health