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NPI Code Detail

MEDICARE: BELLA AMORE ASSISTED LIVING LLC

MEDICARE: BELLA AMORE ASSISTED LIVING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1487410056
Entity Type Code : Organization
Provider Name (Legal Business Name) : BELLA AMORE ASSISTED LIVING LLC
Provider Business Mailing Address
First Line : 3530 W WOOD DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-2146
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3530 W WOOD DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-2146
Country : US
Telephone Number : 507-383-7824
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANTHONY TIPPETT
Credential :
Telephone Number : 507-383-7824
Provider Enumeration Date : 02/22/2024
Last Update Date : 02/22/2024

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Directions to “BELLA AMORE ASSISTED LIVING LLC ” Practice Location

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