Healthcare Provider Details

I. General information

NPI: 1750108536
Provider Name (Legal Business Name): BELLA BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13121 ATLANTIC BLVD STE 100
JACKSONVILLE FL
32225-0102
US

IV. Provider business mailing address

13121 ATLANTIC BLVD STE 100
JACKSONVILLE FL
32225-0102
US

V. Phone/Fax

Practice location:
  • Phone: 904-221-2232
  • Fax:
Mailing address:
  • Phone: 904-221-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DONNA TREESH
Title or Position: OWNER
Credential: DO
Phone: 904-221-2232