Provider Demographics
NPI:1427401546
Name:BELLWOOD ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:BELLWOOD ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-453-4010
Mailing Address - Street 1:3190 CARTHAGE HWY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-9564
Mailing Address - Country:US
Mailing Address - Phone:615-453-4010
Mailing Address - Fax:615-444-0906
Practice Address - Street 1:3190 CARTHAGE HWY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-9564
Practice Address - Country:US
Practice Address - Phone:615-453-4010
Practice Address - Fax:615-444-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN230310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility