Healthcare Provider Details

I. General information

NPI: 1437940269
Provider Name (Legal Business Name): BELLA ANGEL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 W ESTATE DR
COEUR D ALENE ID
83815-6525
US

IV. Provider business mailing address

3570 W ESTATE DR
COEUR D ALENE ID
83815-6525
US

V. Phone/Fax

Practice location:
  • Phone: 208-930-4603
  • Fax: 208-719-8487
Mailing address:
  • Phone: 208-930-4603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: ESTHER MANN
Title or Position: ADMINISTRATOR
Credential:
Phone: 208-930-4603