Provider Demographics
NPI:1912673153
Name:BELLAS HOME HEALTH AND CAREGIVING SERVICES LLC
Entity Type:Organization
Organization Name:BELLAS HOME HEALTH AND CAREGIVING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FINEEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-903-3594
Mailing Address - Street 1:509 S COUNTRY FAIR DR STE A
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-6813
Mailing Address - Country:US
Mailing Address - Phone:217-903-3594
Mailing Address - Fax:217-954-1363
Practice Address - Street 1:509 S COUNTRY FAIR DR STE A
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-6813
Practice Address - Country:US
Practice Address - Phone:217-903-3594
Practice Address - Fax:217-954-1363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5318858Medicaid