Healthcare Provider Details

I. General information

NPI: 1598305237
Provider Name (Legal Business Name): FAITH LA BELLA CADC-I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N STATE ST
HEMET CA
92543-1474
US

IV. Provider business mailing address

1055 N STATE ST
HEMET CA
92543-1474
US

V. Phone/Fax

Practice location:
  • Phone: 951-452-2372
  • Fax:
Mailing address:
  • Phone: 951-452-2372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCI45481224
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: