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General NPI Number Information
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NPI Number | 1275756793
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Entity Type | Organization
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Legal Business Name | BELLA'S GROUP HOME INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 32050 SW 204TH AVE
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City | HOMESTEAD
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State | FL
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Zip | 33030-2600
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Country | US
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Telephone | 305-247-5408
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Fax |
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Provider Business Mailing Address
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Address Line | 7498 W 34TH CT
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City | HIALEAH
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State | FL
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Zip | 33018-1702
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Country | US
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Telephone | 786-942-0924
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EMMA DIAZ
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Credential |
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Telephone | 786-942-0924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | F001
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License Number State | FL
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