Provider Demographics
NPI:1841826997
Name:TERRA BELLA ONE, LLC
Entity type:Organization
Organization Name:TERRA BELLA ONE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH AND WELLNESS
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:813-388-2121
Mailing Address - Street 1:2200 LIVINGSTON RD
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-3416
Mailing Address - Country:US
Mailing Address - Phone:813-388-2121
Mailing Address - Fax:813-388-2138
Practice Address - Street 1:2200 LIVINGSTON RD
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-3416
Practice Address - Country:US
Practice Address - Phone:813-388-2121
Practice Address - Fax:813-388-2138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility