Provider Demographics
NPI:1073911012
Name:BELLA MOM, LLC
Entity Type:Organization
Organization Name:BELLA MOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA & LACTATION COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LENON-REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-600-9006
Mailing Address - Street 1:1280 PACIFIC ST
Mailing Address - Street 2:APT 15
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3154
Mailing Address - Country:US
Mailing Address - Phone:917-600-9006
Mailing Address - Fax:
Practice Address - Street 1:1280 PACIFIC ST
Practice Address - Street 2:APT 15
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3154
Practice Address - Country:US
Practice Address - Phone:917-600-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty