Provider Demographics
NPI:1548776172
Name:BELLAIRE HEALTH & REHABILITATION
Entity Type:Organization
Organization Name:BELLAIRE HEALTH & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENYATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-223-7520
Mailing Address - Street 1:1901 AVENUE OF THE STARS STE 200
Mailing Address - Street 2:
Mailing Address - City:CENTURY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90067-6015
Mailing Address - Country:US
Mailing Address - Phone:310-395-4730
Mailing Address - Fax:909-306-7185
Practice Address - Street 1:1901 AVENUE OF THE STARS STE 200
Practice Address - Street 2:
Practice Address - City:CENTURY CITY
Practice Address - State:CA
Practice Address - Zip Code:90067-6015
Practice Address - Country:US
Practice Address - Phone:310-395-4730
Practice Address - Fax:909-306-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X, 225X00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty