Provider Demographics
NPI:1104439835
Name:BELLA-ROUGE HEALTH CARE INC
Entity type:Organization
Organization Name:BELLA-ROUGE HEALTH CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DNP
Authorized Official - Prefix:
Authorized Official - First Name:BLANCHE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:305-978-4907
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39121-0070
Mailing Address - Country:US
Mailing Address - Phone:225-433-3172
Mailing Address - Fax:601-228-4471
Practice Address - Street 1:4510 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-6016
Practice Address - Country:US
Practice Address - Phone:225-433-3172
Practice Address - Fax:601-228-4471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty