Provider Demographics
NPI:1427171271
Name:BELL CLUB, INC.
Entity type:Organization
Organization Name:BELL CLUB, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:HILEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-848-5767
Mailing Address - Street 1:160 S. GEORGE STREET
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-1408
Mailing Address - Country:US
Mailing Address - Phone:717-848-5767
Mailing Address - Fax:
Practice Address - Street 1:3955 WEST MARKET STREET
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404
Practice Address - Country:US
Practice Address - Phone:717-792-2976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA320210251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000050910042OtherPROMISE ID NUMBER
PA1000050910031OtherPROMISE ID NUMBER