Provider Demographics
NPI:1407294697
Name:BELL CHEMICAL DEPENDENCY OUNSELING INC.
Entity Type:Organization
Organization Name:BELL CHEMICAL DEPENDENCY OUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMFT
Authorized Official - Phone:208-459-6557
Mailing Address - Street 1:2719 S KIMBALL AVE
Mailing Address - Street 2:P.O. BOX 1022 EMMETT, ID 83617
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-5623
Mailing Address - Country:US
Mailing Address - Phone:208-459-6557
Mailing Address - Fax:208-453-8847
Practice Address - Street 1:2719 S KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5623
Practice Address - Country:US
Practice Address - Phone:208-459-6557
Practice Address - Fax:208-453-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health