Healthcare Provider Details

I. General information

NPI: 1407449218
Provider Name (Legal Business Name): BELLADAIRE HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 E CENTER ST
DOWNEY ID
83234-1692
US

IV. Provider business mailing address

PO BOX 18998
SALT LAKE CITY UT
84118-0998
US

V. Phone/Fax

Practice location:
  • Phone: 385-271-3018
  • Fax:
Mailing address:
  • Phone: 385-271-3018
  • Fax:

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: TAYLOR CHIU
Title or Position: OWNER
Credential:
Phone: 385-271-3018