Organization
BELLROAD HUMAN SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE PEASE (PRESIDENT)
(850) 539-8510
Entity
Organization
Contact information
Practice address
182 BELL RD, HAVANA, FL 32333-3770
(850) 539-8510
Mailing address
182 BELL RD, HAVANA, FL 32333-3770
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140747300
—
FL
05
—
673567396
—
FL
Enumeration date
04/15/2013
Last updated
04/15/2013
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