Organization
BELLEMEADE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN MULSOW (ADMINISTRATOR)
(510) 754-8294
Entity
Organization
Contact information
Practice address
29255 RUUS RD, HAYWARD, CA 94544-6334
(510) 754-8294
Mailing address
PO BOX 95, MOUNT EDEN, CA 94557-0095
(510) 754-8294
(510) 537-1741
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
0200000419
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC60559F
LTC PROVIDER NUMBER
CA
Enumeration date
01/15/2007
Last updated
08/22/2020
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