Healthcare Provider Details

I. General information

NPI: 1588078125
Provider Name (Legal Business Name): BELLA HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2418 PARK AVE APT 306
MINNEAPOLIS MN
55404-3999
US

IV. Provider business mailing address

2418 PARK AVE APT 306
MINNEAPOLIS MN
55404-3999
US

V. Phone/Fax

Practice location:
  • Phone: 612-483-1875
  • Fax:
Mailing address:
  • Phone: 612-483-1875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: ASHA HUSSEIN MOHAMED
Title or Position: CEO
Credential:
Phone: 612-483-1875