Provider Demographics
NPI:1790157964
Name:BELLAH THERAPIES LLC
Entity Type:Organization
Organization Name:BELLAH THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINCAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:254-394-2710
Mailing Address - Street 1:1200 EAST FM 2410 SUITE D
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-0369
Mailing Address - Country:US
Mailing Address - Phone:254-394-2710
Mailing Address - Fax:254-307-9700
Practice Address - Street 1:1200 E FM 2410 RD STE D
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-6898
Practice Address - Country:US
Practice Address - Phone:254-394-2710
Practice Address - Fax:254-442-0720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1177343261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy