Organization
THE ATRIUM OF BELLMEAD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL G. WALLACE (PRESIDENT)
(940) 387-4388
Entity
Organization
Contact information
Practice address
2401 DEVELOPMENT BLVD, BELLMEAD, TX 76705-2903
(254) 296-8976
(254) 296-8993
Mailing address
401 N ELM ST, DENTON, TX 76201-4137
(940) 387-4388
(940) 380-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001019484
—
TX
01
—
287429901
MEDICAID CO B CROSS-OVER
TX
Enumeration date
03/22/2011
Last updated
03/06/2012
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