Provider Demographics
NPI:1912590571
Name:SME II-BELMONT/GOLDEN, LLC
Entity Type:Organization
Organization Name:SME II-BELMONT/GOLDEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYLL
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-929-7536
Mailing Address - Street 1:267 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:MS
Mailing Address - Zip Code:38847-9701
Mailing Address - Country:US
Mailing Address - Phone:662-454-0544
Mailing Address - Fax:
Practice Address - Street 1:267 FRONT ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:MS
Practice Address - Zip Code:38847-9701
Practice Address - Country:US
Practice Address - Phone:662-454-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility