Healthcare Provider Details

I. General information

NPI: 1407684699
Provider Name (Legal Business Name): LA BELLA FLEUR HEALTHCARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 S QUEBEC ST
GREENWOOD VILLAGE CO
80111-2004
US

IV. Provider business mailing address

PO BOX 6011
BROOMFIELD CO
80021-0001
US

V. Phone/Fax

Practice location:
  • Phone: 720-334-7741
  • Fax: 303-835-7202
Mailing address:
  • Phone: 720-334-7741
  • Fax: 303-835-7202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0001X
TaxonomyClinical & Laboratory Immunology (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080I0007X
TaxonomyPediatric Clinical & Laboratory Immunology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name: JANE'T T ESPINOZA
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 301-368-4286