Provider Demographics
NPI:1548010101
Name:BELLA AT YOUR BEDSIDE
Entity type:Organization
Organization Name:BELLA AT YOUR BEDSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:JAMEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEPBURN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:313-231-6627
Mailing Address - Street 1:28763 NORTHWESTERN HWY STE 100A
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1842
Mailing Address - Country:US
Mailing Address - Phone:248-327-6888
Mailing Address - Fax:248-327-6624
Practice Address - Street 1:28763 NORTHWESTERN HWY STE 100A
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1842
Practice Address - Country:US
Practice Address - Phone:248-327-6888
Practice Address - Fax:248-327-6624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty