Provider Demographics
NPI:1083592406
Name:BELLAMERE MANORS LLC
Entity type:Organization
Organization Name:BELLAMERE MANORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-481-5804
Mailing Address - Street 1:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-0024
Mailing Address - Country:US
Mailing Address - Phone:678-481-5804
Mailing Address - Fax:678-550-9233
Practice Address - Street 1:8647 FOREST POINTE DR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-4362
Practice Address - Country:US
Practice Address - Phone:770-240-7474
Practice Address - Fax:678-550-9322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health