Provider Demographics
NPI:1073185724
Name:BELLELLA HOME CARE, LLC
Entity Type:Organization
Organization Name:BELLELLA HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JELKS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:904-524-5829
Mailing Address - Street 1:13990 BARTRAM PARK BLVD UNIT 1020
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5552
Mailing Address - Country:US
Mailing Address - Phone:904-210-3828
Mailing Address - Fax:
Practice Address - Street 1:13990 BARTRAM PARK BLVD UNIT 1020
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-5552
Practice Address - Country:US
Practice Address - Phone:904-524-5829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty