Healthcare Provider Details

I. General information

NPI: 1790614568
Provider Name (Legal Business Name): BELA PRO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5940 KITTY HAWK DR
RIVERSIDE CA
92504-1444
US

IV. Provider business mailing address

5940 KITTY HAWK DR
RIVERSIDE CA
92504-1444
US

V. Phone/Fax

Practice location:
  • Phone: 951-545-2231
  • Fax: 951-324-1266
Mailing address:
  • Phone: 951-545-2231
  • Fax: 951-324-1266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: RUBY BELARMINO
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 954-261-1948