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General NPI Number Information
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NPI Number | 1962368621
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Entity Type | Organization
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Legal Business Name | BELLA LUNA CARE HOME INC
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 1311 W ANAHEIM ST
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City | WILMINGTON
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State | CA
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Zip | 90744-4109
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Country | US
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Telephone | 562-577-6299
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Fax |
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Provider Business Mailing Address
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Address Line | 8516 ARTESIA BLVD
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City | BELLFLOWER
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State | CA
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Zip | 90706-6102
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Country | US
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Telephone | 562-272-8007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL BOLONG
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Credential |
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Telephone | 562-577-6299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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