Healthcare Provider Details

I. General information

NPI: 1073185724
Provider Name (Legal Business Name): BELLELLA HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13990 BARTRAM PARK BLVD UNIT 1020
JACKSONVILLE FL
32258-5552
US

IV. Provider business mailing address

13990 BARTRAM PARK BLVD UNIT 1020
JACKSONVILLE FL
32258-5552
US

V. Phone/Fax

Practice location:
  • Phone: 904-524-5829
  • Fax:
Mailing address:
  • Phone: 904-210-3828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: SHARON JELKS
Title or Position: OWNER
Credential: RN
Phone: 904-524-5829