Organization
BELLA ROSE HEALTHCARE L.L.C.
Active
Other names
Serenity Personal Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
ANTIONETTE MUNDY LPN, LTC ADMIN (OWNER/ADMINISTRATOR)
(762) 822-9567
Entity
Organization
Contact information
Practice address
7661 KAYNE BLVD STE A, COLUMBUS, GA 31909-2546
(706) 221-3520
(706) 221-3522
Mailing address
7661 KAYNE BLVD STE A, COLUMBUS, GA 31909-2546
(706) 221-3520
(706) 221-3522
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PCH012233
DEPARTMENT OF COMMUNITY HEALTH
GA
Enumeration date
12/27/2023
Last updated
12/27/2023
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