Healthcare Provider Details

I. General information

NPI: 1841805595
Provider Name (Legal Business Name): BELLA HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 ASTER CT
ROMEOVILLE IL
60446-5122
US

IV. Provider business mailing address

357 ASTER CT
ROMEOVILLE IL
60446-5122
US

V. Phone/Fax

Practice location:
  • Phone: 815-274-5202
  • Fax:
Mailing address:
  • Phone: 815-274-5202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: ROSE AMPADU
Title or Position: OWNER
Credential: APN
Phone: 815-274-5202