Provider Demographics
NPI:1962869974
Name:BEL AIRE RETIREMENT HOME
Entity type:Organization
Organization Name:BEL AIRE RETIREMENT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:CARTIA
Authorized Official - Last Name:REGNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-286-4484
Mailing Address - Street 1:9955 SW 196 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:CUTLER BAY
Mailing Address - Zip Code:33157
Mailing Address - Country:UM
Mailing Address - Phone:305-232-0429
Mailing Address - Fax:786-228-0984
Practice Address - Street 1:9955 SW 196TH ST
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-8665
Practice Address - Country:US
Practice Address - Phone:305-232-0429
Practice Address - Fax:786-228-0984
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAIRWAY PARK RETIREMENT FACILITY, CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-21
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL106923104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142538200Medicaid