Provider Demographics
NPI:1851752406
Name:BAILEY BELKNAP LLC
Entity Type:Organization
Organization Name:BAILEY BELKNAP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BAILEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELKNAP
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:614-377-7379
Mailing Address - Street 1:142 FENWAY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214
Mailing Address - Country:US
Mailing Address - Phone:614-377-7379
Mailing Address - Fax:
Practice Address - Street 1:623-H PARK MEADOW RD.
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-774-1120
Practice Address - Fax:855-740-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 1430046261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)