# STONEWALL RESIDENTIAL CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700200011
- **Authorized official:** ANGELA CAROL BELLAR RN (OWNER/PROVIDER)
- **Authorized official phone:** (509) 413-9129

## Contact information

- **Practice address:** 28921 N. RIVER ESTATES, CHATTAROY, WA 99003
- **Practice address phone:** (509) 413-9129
- **Practice address fax:** (509) 209-5684
- **Mailing address:** 28921 N. RIVER ESTATES, CHATTAROY, WA 99003
- **Mailing address phone:** (509) 413-9129
- **Mailing address fax:** (509) 209-5684

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 751213 | WA | Yes |

## Other

- **Enumeration date:** 02/06/2014
- **Last updated:** 02/06/2014