Provider Demographics
NPI:1841805595
Name:BELLA HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:BELLA HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMPADU
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:815-274-5202
Mailing Address - Street 1:357 ASTER CT
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5122
Mailing Address - Country:US
Mailing Address - Phone:815-274-5202
Mailing Address - Fax:
Practice Address - Street 1:357 ASTER CT
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-5122
Practice Address - Country:US
Practice Address - Phone:815-274-5202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL192727872001Medicaid