Provider Demographics
NPI:1124668124
Name:BELLE VIE THERAPIES LLC
Entity type:Organization
Organization Name:BELLE VIE THERAPIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIGORAC
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTRL, CATP
Authorized Official - Phone:810-623-0947
Mailing Address - Street 1:1547 SHORE CLUB DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1574
Mailing Address - Country:US
Mailing Address - Phone:313-444-3515
Mailing Address - Fax:313-556-1373
Practice Address - Street 1:20816 E 11 MILE RD STE 105
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1578
Practice Address - Country:US
Practice Address - Phone:313-444-3515
Practice Address - Fax:313-556-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1316441280Medicaid
MI1316441280Medicaid