Provider Demographics
NPI:1437400033
Name:BEWELL REHABILITATION AND COUNSELING GROUP, INC
Entity Type:Organization
Organization Name:BEWELL REHABILITATION AND COUNSELING GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-367-6261
Mailing Address - Street 1:212 NE 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4230
Mailing Address - Country:US
Mailing Address - Phone:954-367-6261
Mailing Address - Fax:954-374-8908
Practice Address - Street 1:212 NE 1ST AVE
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4230
Practice Address - Country:US
Practice Address - Phone:954-367-6261
Practice Address - Fax:954-374-8908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty