Provider Demographics
NPI:1841839727
Name:BELLVIEW ADVOCACY PROJECT LLC
Entity type:Organization
Organization Name:BELLVIEW ADVOCACY PROJECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:TANYIKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-295-5482
Mailing Address - Street 1:14606 DALLAS PKWY APT 1111
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7451
Mailing Address - Country:US
Mailing Address - Phone:480-295-5482
Mailing Address - Fax:480-546-4950
Practice Address - Street 1:14606 DALLAS PKWY APT 1111
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7451
Practice Address - Country:US
Practice Address - Phone:480-295-5482
Practice Address - Fax:480-546-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-25
Last Update Date:2019-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities