Provider Demographics
NPI:1265149157
Name:BELAC HEATH LLC DBA PROJECT MOSHEH
Entity type:Organization
Organization Name:BELAC HEATH LLC DBA PROJECT MOSHEH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCRIBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-364-0750
Mailing Address - Street 1:13182 LA MIRADA CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3997
Mailing Address - Country:US
Mailing Address - Phone:773-364-0750
Mailing Address - Fax:
Practice Address - Street 1:990 QUAYE LAKE CIR APT 103
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33411-5072
Practice Address - Country:US
Practice Address - Phone:773-364-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
17341OtherFLORIDA LIC #