Stonewall Residential Care, LLC

NPI #1700200011 in Chattaroy, Washington

Provider Information

NPI Number: 1700200011
Entity Type: Organization
Organization Name: Stonewall Residential Care, LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 6, 2014
Last Updated: Feb 6, 2014

Practice Location

Address: 28921 N. RIVER ESTATES
City: Chattaroy
State: Washington
ZIP Code: 99003
Phone: (509) 413-9129

Authorized Official

Name: ANGELA CAROL BELLAR, RN
Title: OWNER/PROVIDER
Phone: (509) 413-9129

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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