Provider Demographics
NPI:1922434802
Name:BELLA ROSE ALF INC.
Entity Type:Organization
Organization Name:BELLA ROSE ALF INC.
Other - Org Name:BELLA ROSE ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-410-0828
Mailing Address - Street 1:804 W YUKON ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-1236
Mailing Address - Country:US
Mailing Address - Phone:813-410-0828
Mailing Address - Fax:813-644-4833
Practice Address - Street 1:804 W YUKON ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-1236
Practice Address - Country:US
Practice Address - Phone:813-410-0828
Practice Address - Fax:813-644-4833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12409310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility